Device-based controlled local delivery for the treatment of peritoneal pathologies

This contribution aims at reporting the developpment of a controlled drug delivery system (DDS) dedicated to the treatment of intra-peritoneal pathologies, especially endometriosis. At present time, endometriosis is generally treated by daily oral absorption of drug with the purpose to improve the life quality of patients by the reduction of the pain caused by endometrial lesions. Nevertheless, deleterious side-effects, mainly infertility, are observed as a consequence of the important amount of absorbed active principle. One main advantage of controlled drug delivery devices, e.g. polymer implants, is to maintain sustained drug release over a prolonged period of time thereby eliminating fluctuations in the drug plasma concentration. Moreover, DDS allows a local release of the drug at a specific area, which significantly decreases the active principle concentration in the body and limits side-effects. The peritoneal cavity is a convenient site for the implantation of a DDS against endometriosis because large parts of lesion are localized in this region. At our knowledge, no application of an implant dedicated to the treatment of endometriosis is reported in the literature, whereas the local controlled release of an active principle presents several advantages compared to systemic administration. In this study, anastrozole (2,2’-[5-1H-1,2,4-triazole-1-yl-methyl)-1,3-phenylene]bis(2-methylpropiononitrile)), a well-known aromatase-inhibiting drug, was selected as active molecule. Typically, two non-biodegradable polymers were tested for the elaboration of an anastrozole loaded intra-peritoneal implant, namely polydimethylsiloxane (PDMS) and poly(ethylene-co-vinyl acetate) (EVA). As preliminary research, the ‘in vivo’ biocompatibility of PDMS and EVA in the intra-peritoneal cavity was confirmed by implantation of PDMS and EVA rod-shaped implants in rats. The kinetic of release was determined ‘in vitro’ and confirmed ‘in vivo’. Besides, the efficiency of the implants was improved by the addition of a polymer membrane, which allowed a controlled release of anastrozole over a period of 400 days.