title: New drug delivery systems in inflammatory bowel disease: MMX and tailored delivery to the gut.
abstract: Inflammatory bowel diseases are chronic diseases that affect the gastrointestinal tract. Mesalamine, corticosteroids, immunosuppressants and biological agents are currently used to treat these diseases. Due to inadequacies of the currently available delivery systems, a large number of patients do not respond to treatment, especially when they are affected by distal colonic disease. Multimatrix (MMX) technology comprises hydrophilic and lipophilic excipients, enclosed within a gastro-resistant, pH-dependent coating. This new delivery technology has been used to modify some commonly used drugs, including mesalamine and budesonide, as well as heparin, which are now being investigated for their utility in the management of IBD.
  
  
  OBJECTIVE
  The aim of this review is to explore the MMX delivery technology and its efficacy for the treatment of IBD.
  
  
  RESULTS
  The results of various studies involving MMX drugs have been published. Mesalamine MMX induces clinical and endoscopic remission in patients with mild to moderate ulcerative colitis (UC) compared with placebo. Positive results have also been observed with MMX budesonide in two phase I studies. In a pilot study involving ten patients with UC, efficacy of heparin-MMX as an IBD therapy was observed.
  
  
  CONCLUSIONS
  MMX is a promising new delivery system that can improve efficacy of current and new drugs, augmenting targeting to the affected tract, thereby increasing response and remission rates for those drugs in patients with IBD.
authors.affiliation: Gastroenterology Unit, Istituto Clinico Humanitas, Rozzano, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Fiorino
authors.forename: W
authors.initials: W
authors.lastname: Fries
authors.forename: S A
authors.initials: SA
authors.lastname: De La Rue
authors.forename: A C
authors.initials: AC
authors.lastname: Malesci
authors.forename: A
authors.initials: A
authors.lastname: Repici
authors.forename: S
authors.initials: S
authors.lastname: Danese
mesh_terms: D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D002986:Clinical Trials as Topic; D016503:Drug Delivery Systems / Q000379:methods*; D005079:Excipients / Q000008:administration & dosage; D005765:Gastrointestinal Agents / Q000008:administration & dosage*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D019804:Mesalamine / Q000008:administration & dosage
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005079:Excipients; D005765:Gastrointestinal Agents; D019804:Mesalamine