Translational medicine in the field of ablative fractional laser (AFXL)-assisted drug delivery: A critical review from basics to current clinical status

Merete Haedersdal, Andrés M Erlendsson, Uwe Paasch, R Rox Anderson

144 Citations (Scopus)

Abstract

BACKGROUND: Ablative fractional lasers enhance uptake of topical therapeutics and the concept of fractional laser-assisted drug delivery has now been taken into clinical practice.

OBJECTIVES: We systematically reviewed preclinical data and clinical evidence for fractional lasers to enhance drug uptake and improve clinical efficacy.

METHODS: We searched PubMed and Embase databases; 34 articles met the inclusion criteria. Studies were categorized into experimental preclinical studies and clinical trials, the latter graded according to level of evidence.

RESULTS: All preclinical trials (n = 16) documented enhanced topical drug uptake into skin after ablative fractional laser treatment. Clinical evidence encompassed 18 studies, of which 9 were randomized controlled trials and 2 were controlled trials, examining neoplastic lesions, photodamaged skin, scars, onychomycosis, and topical anesthetics. The highest level of evidence was reached for actinic keratoses treated with methylaminolevulinate for photodynamic therapy (level IB, 5 randomized controlled trials), substantiating superior and long-lasting efficacy versus conventional photodynamic therapy. No adverse events were reported, but ablative fractional laser-assisted drug delivery implies risks of systemic drug absorption, especially when performed over large skin areas.

CONCLUSIONS: Fractional laser-assisted drug delivery is beneficial in enhancing preclinical and clinical outcomes for certain skin conditions.

Original languageEnglish
JournalJournal of the American Academy of Dermatology
Volume74
Issue number5
Pages (from-to)981-1004
Number of pages24
ISSN0190-9622
DOIs
Publication statusPublished - May 2016

Keywords

  • Administration, Cutaneous
  • Aminolevulinic Acid
  • Anesthetics
  • Animals
  • Cicatrix
  • Controlled Clinical Trials as Topic
  • Dermatologic Agents
  • Disease Models, Animal
  • Drug Delivery Systems
  • Evidence-Based Medicine
  • Female
  • Follow-Up Studies
  • Forecasting
  • Humans
  • Low-Level Light Therapy
  • Male
  • Onychomycosis
  • Patient Safety
  • Photochemotherapy
  • Quality Improvement
  • Randomized Controlled Trials as Topic
  • Skin Diseases
  • Skin Neoplasms
  • Swine
  • Translational Medical Research
  • Treatment Outcome
  • Journal Article
  • Review

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