title: Microneedles permit transdermal delivery of a skin-impermeant medication to humans.
abstract: Drugs with poor oral bioavailability usually are administered by hypodermic injection, which causes pain, poor patient compliance, the need for trained personnel, and risk of infectious disease transmission. Transdermal (TD) delivery provides an excellent alternative, but the barrier of skin's outer stratum corneum (SC) prevents delivery of most drugs. Micrometer-scale microneedles (MNs) have been used to pierce animal and human cadaver skin and thereby enable TD delivery of small molecules, proteins, DNA, and vaccines for systemic action. Here, we present a clinical study of MN-enhanced delivery of a medication to humans. Naltrexone (NTX) is a potent mu-opioid receptor antagonist used to treat opiate and alcohol dependence. This hydrophilic and skin-impermeant molecule was delivered from a TD patch to healthy human subjects with and without pretreatment of the skin with MNs. Whereas delivery from a standard NTX TD patch over a 72-h period yielded undetectable drug plasma levels, pretreatment of skin with MNs achieved steady-state plasma concentrations within 2 h of patch application and were maintained for at least 48 h. The MNs and NTX patch were well tolerated with mild systemic and application site side effects. The MN arrays were painless upon administration and not damaged during skin insertion, and no MNs were broken off into the skin. This human proof-of-concept study demonstrates systemic administration of a hydrophilic medication by MN-enhanced TD delivery. These findings set the stage for future human studies of skin-impermeant medications and biopharmaceuticals for clinical applications.
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, University of Kentucky, Lexington, KY 40536, USA. dwermel@uky.edu
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Wermeling
authors.forename: Stan L
authors.initials: SL
authors.lastname: Banks
authors.forename: David A
authors.initials: DA
authors.lastname: Hudson
authors.forename: Harvinder S
authors.initials: HS
authors.lastname: Gill
authors.forename: Jyoti
authors.initials: J
authors.lastname: Gupta
authors.forename: Mark R
authors.initials: MR
authors.lastname: Prausnitz
authors.forename: Audra L
authors.initials: AL
authors.lastname: Stinchcomb
mesh_terms: D000279:Administration, Cutaneous; D001682:Biological Availability; D005260:Female; D006801:Humans; D008297:Male; D009339:Needles; D012869:Skin Absorption