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Targeted Drug Delivery to the CNS: Beyond the Intrathecal Space

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Neuraxial Therapeutics

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Abstract

The promise of direct delivery of medications to the brain to help patients with severe central nervous system (CNS) diseases has made some progress in the last few years but has yet to be fully realized. For targeted brain delivery, a drug can be administered into the cerebrospinal fluid or directly into the brain parenchyma. With either route of administration, the use of targeted drug delivery to the brain seeks to gain the same attendant advantages that have been recognized with intrathecal (IT) drug delivery, particularly to bypass or circumvent the blood-brain barrier and infuse a drug in direct proximity to target regions within the brain. Ideally, the optimal combination of the right drug, device, and delivery regimen will yield a distribution of the drug (both spatially and temporally) within the brain at an appropriate dose that matches the therapeutic needs of the patient and yields a therapy that provides a degree of clinical benefit that exceeds the inherent risks of this approach. This chapter provides a historical perspective on targeted drug delivery to the brain, identifies practical considerations for drug-device combination development, and identifies indications with the most promise for therapeutic success.

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Authors and Affiliations

  1. Cerebral Therapeutics, Aurora, CO, USA

    Daniel J. Abrams

  2. Alchemy Neuroscience, Chanhassen, MN, USA

    Gregory R. Stewart

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  1. Daniel J. Abrams
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  1. (CTF-312), UC San Diego-Anesthesia Res Lab 081 (CTF-312), La Jolla, CA, USA

    Tony Yaksh

  2. University Hospital, Case Western Reserve University, Cleveland, OH, USA

    Salim Hayek

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Abrams, D.J., Stewart, G.R. (2023). Targeted Drug Delivery to the CNS: Beyond the Intrathecal Space. In: Yaksh, T., Hayek, S. (eds) Neuraxial Therapeutics. Springer, Cham. https://doi.org/10.1007/978-3-031-39558-1_24

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