Clinical evaluation of microbicide formulations.
The clinical evaluation of microbicide formulations presents variable and interacting challenges. Specific domains of acceptability, pharmacokinetics, and toxicity interact with each other to potentially inhibit or enhance a microbicide's efficacy. Each of these is further influenced by application and use parameters in the relative presence (or absence) of vaginal and/or seminal fluids, ultimately impacting effectiveness. Historically, acceptability of formulation and use parameters, and their concomitant behavioral influences, have been considered separately from pharmacokinetics and toxicity. While independent evaluation of these elements is necessary in some respects, we must acknowledge that this approach is not sufficient for the successful development of microbicides. Each needs to be considered in an integrated clinical evaluation strategy. This article presents the rationale for such an approach. This article forms part of a special supplement covering two presentations on clinical evaluation of microbicides from the symposium on "Recent Trends in Microbicide Formulations" held on 25 and 26 January 2010, Arlington, VA.
The Miriam Hospital and The Warren Alpert Medical School of Brown University, CBPM, Coro West, 1 Hoppin Street, Providence, RI 02903, USA. kmorrow@lifespan.org
Kathleen M
KM
Morrow
Craig
C
Hendrix
D000282:Administration, Intravaginal; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002626:Chemistry, Pharmaceutical; D002986:Clinical Trials as Topic; D004304:Dosage Forms; D004347:Drug Interactions; D004335:Drug and Narcotic Control; D005260:Female; D006678:HIV / Q000187:drug effects*; D015658:HIV Infections / Q000188:drug therapy* / Q000517:prevention & control* / Q000635:transmission*; D054884:Host-Pathogen Interactions / Q000187:drug effects; D006801:Humans; D008297:Male; D012725:Sexual Behavior; D014621:Vagina / Q000187:drug effects / Q000821:virology
D019380:Anti-HIV Agents; D000891:Anti-Infective Agents, Local; D004304:Dosage Forms