Drug delivery in female reproductive health

EDITORIAL Drug delivery in female reproductive health David R. Friend 1 Published online: 11 September 2017 # Controlled Release Society 2017 Editorial This theme issue has its origin in a previous theme issue on BAdvances in V aginal Drug Delivery^ published in Drug Delivery and Translational Researchin June 2011. That issue was based on a scientific session at the Controlled Release Society Annual Meeting held in Portland, OR, in July 2010. The goal for the current theme is to provide a more expansive look at drug delivery as it rela tes to female reproductive health. A key aspect of female reproductive health remains fo- cused on prevention of sexual transmission of HIV . Due to the inability to demonstrate successful clinical outcomes using pericoital (on-demand) vaginally administered products, there is increasing emphasis on the use of long-acting delivery sys- tems. A key perceived advantage of long-acting dosage forms is that adherence will be substantially improved compared with that seen with pericoital products such as tenofovir vag- inal gel [ 1]. Desai and coworkers [ 2] examined the field of long-acting systemic HIV pre-exposure prophylaxis. These long-acting systems fall into one of two general categories: injectable and implantable. One of the more interesting prod- ucts under development relies on the extended release of cabotegravir (an integrase inhibitor). Due to potency, the abil- ity to deliver antiviral drugs at effective levels will probably be no longer than 1 year and in some cases, no longer than 3m o n t h s . Despite challenges observed with pericoital administration of vaginal gels, work continues on development of on- demand products for HIV and other STI prevention. Patel and Rohan have contributed an article covering on-demand microbicide products [ 3] including vaginal gels, films, and inserts (tablets). Woodrow and coworkers have provided their insights into use of electrospun fibers in female reproductive health [4]. Electrospun fibers have potential in prevention of acquisition of STIs including HIV , contraception, other repro- ductive tract infections, and in the field of multipurpose pre- vention technologies (MPTs). Cervical cancer remains a serious health concern for wom- en. Since the cervix is accessible through the vagina, localized delivery of chemotherapeutic drugs is reviewed by McConville and Major [ 5]. There are several vaginal dosage forms being investigated for treatment and reduction of recur- rence of cervical cancer includ ing inserts (tablets), rings, bioadhesive dosage forms, as well as cervical caps. Two other female reproductive conditions affecting many women world- wide are endometriosis and uterine fibroids. The use of drug delivery to address these two conditions has been reviewed [6]. Drug delivery for these conditions relies on marketed products (primarily contraceptives). In addition, newer ap- proaches involving nanotechnology are under investigation. Included in this issue are two articles (one an original arti- cle and another a short communication). The former describes research on a MPT product that can potentially release three antiviral agents and a contraceptive [ 7]. The latter article re- ports on the anti-HIV activity of MIV-150, a non-nucleoside reverse transcriptase inhibitor and zinc acetate [8]. References 1. Marrazzo JM, Ramjee G, Richardson BA, Gomez K, Mgodi N, Nair G, et al. Tenofovir-based preexposure prophylaxis for HIV infection among African women. N Engl J Med. 2015;372(6):509–18. https:// doi.org/10.1056/NEJMoa1402269. * David R. Friend [email protected] 1 Evofem Biosciences, Inc., San Diego, CA 92130, USA Drug Deliv. and Transl. Res. (2017) 7:773–774 DOI 10.1007/s13346-017-0427-y 2. Lykins WR, Luecke E, Johengen D, van der Straten A, Desai TA. Long acting systemic HIV pre-exposure prophylaxis: an examination of the field. Drug Delivery and Translational Research. 2017;https:// doi.org/10.1007/s13346-017-0391-6. 3. Patel SK, Rohan LC. On-demand microbicide products: design mat- ters. Drug Delivery and Translational Research. 2017; https://doi. org/10.1007/s13346-017-0385-4. 4. Blakney AK, Jiang Y , Woodrow KA. Application of electrospun fibers for female reproductive health. Drug Delivery and Translational Research. 2017; https://doi.org/10.1007/s13346-017- 0386-3. 5. Major I, McConville C. V aginal drug delivery for the localised treat- ment of cervical cancer. Drug Delivery and Translational Research. 2017; https://doi.org/10.1007/s13346-017-0395-2. 6. Friend DR. Drug delivery for the treatment of endometriosis and uterine fibroids. Drug Delivery and Translational Research. 2017; https://doi.org/10.1007/s13346-017-0423-2. 7. Derby N, Aravantinou M, Kenney J, Ugaonkar SR, Wesenberg A, Wilk J, et al. An intravaginal ring that releases three antiviral agents and a contraceptive blocks SHIV -RT infection, reduces HSV -2 shed- ding, and suppresses hormonal cycling in rhesus macaques. Drug Delivery and Translational Research. 2017; https://doi.org/10.1007/ s13346-017-0389-0. 8. Mizenina O, Hsu M, Jean-Pierre N, Aravantinou M, Levendosky K, Paglini G, et al. MIV -150 and zinc acetate combination provides potent and broad activity against HIV-1. Drug Delivery and Translational Research. 2017; https://doi.org/10.1007/s13346-017- 0421-4. 774 Drug Deliv. and Transl. Res. (2017) 7:773–774