Strategies to modulate immune cell trafficking across the blood-brain barrier have informed our understanding of neurological disease.

Learning CNS immunopathology from therapeutic interventions | Science Translational Medicine

Background: Handheld percussive massage therapy devices like massage guns have gained much popularity in both the medical and athletic setting. Its applications have been prominently recognized in injury prevention and rehabilitation across a wide variety of populations. While massage guns hold similarities to alternate and more studied therapeutic modalities, there is still limited evidence-based information on the indications and contraindications for said devices. Objective: This study aims utilize a qualitative analysis of consumer perceptions to establish an understanding of the perceived therapeutic potential as well as points of concern of massage guns. Methods: A search of Amazon’s best-selling massage gun was conducted, and a qualitative analysis was performed on the top 100 positive comments and top 100 critical comments. Results: Four pertinent themes were identified upon qualitative analysis: Pain Management, Versatility, Accessibility, and Safety and Education. Consumers identified therapeutic potential of percussive massage therapy in managing acute pain, chronic pain, non-surgical injury rehabilitation, post-surgical injury rehabilitation, and injury prevention. In regard to accessibility, consumers frequently commented on the ability of at-home percussive therapy devices to improve availability and affordability. Consumers highlighted versatility of the device to address person-specific needs as a key feature in its perceived therapeutic benefits. The most stated point of concern included the quality of the device itself. However, this concern did not translate to the overall modality of percussive massage therapy devices. Conclusions: Massage guns hold value in regard to its perceived efficacy in pain management of acute and chronic conditions as well as in injury prevention and rehabilitation. Additionally, massage guns were perceived to improve healthcare accessibility by establishing a reliable and affordable resource for home-based health interventions of diverse medical needs. However, limited scientific research on massage guns raises concerns for lack of regulated and evidence-based care.

Home-Based Therapeutic Interventions: A Qualitative Analysis of Consumer Perceptions of Percussive Massage Guns

Economic Evaluation Associated With Clinical-Grade Mobile App–Based Digital Therapeutic Interventions: Systematic Review

Background: A new class of interventions called digital therapeutics (DTx) is emerging and shows promise in the treatment of a spectrum of medical disorders and diseases. DTx are software-based interventions which could deliver unprecedented portability and scalability for patients. Their adoption and implementation were accelerated by the need for remote care during the COVID-19 pandemic, and awareness about their utility grew among health care providers, payers, and regulators. Yet, despite increasing clinical evidence that DTx can prevent, manage, or treat chronic conditions and disorders, the digital nature of these technologies creates a new set of challenges to evaluating their cost-effectiveness. As a result, little is known regarding the capacity of DTx to provide economic value to payers, providers, and health systems. Objective: This study aims to systematically review and summarize published evidence regarding the cost-effectiveness of clinical-grade mobile application-based DTx, as well as explore factors affecting such evaluations. Methods: A systematic review of economic evaluations of clinical-grade mobile application-based DTx was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Major electronic databases (including PubMed, Cochrane Library, and Web of Science) were searched for eligible studies published from inception to October 28, 2022. Two independent reviewers evaluated the eligibility of all retrieved articles for inclusion. The methodological quality and risk of bias were assessed for included studies. Results: The search yielded 11,228 abstracts, of which 18 studies are included in this review. Of the 18 studies, 7 (39%) are non-randomized studies-based economic evaluations, 6 (33%) are model-based evaluations and 5 (28%) are randomized clinical trials-based evaluations. Twelve of the studies (67%) used a payer perspective for the economic analysis, while the rest (33%) used a societal perspective. Thirteen of the studies (72%) conducted a full economic evaluation, and 12 of those (92%) found the DTx intervention under assessment to be cost-effective; one study (8%) found the intervention to be cost-effective in only one of the three countries of study. The remaining 5 studies (28%), which focused on a partial economic evaluation, found the DTx intervention under assessment to be cost-saving. Across the 18 studies included in this review, health care resource utilization was the most often reported cost impacting the DTx economic value of the DTx interventions (16/18, 89%), followed by the cost of the pharmaceutical treatment (12/18, 67%). The participants’ baseline characteristics was the most often reported factors influencing DTx economic impact in 12 of the studies (67%). By way of limitations, qualitative deficits in methodology and significant potential biases, including risks of performance bias and of selection bias in participant recruitment, were identified across some of the studies. Conclusions: This systematic review supports the thesis that DTx interventions have potential economic benefits. However, the distinctive nature of DTx creates a new set of challenges to evaluating such novel technologies, which were not consistently addressed across studies. To provide evidence of economic impact, which is required for DTx adoption and deployment, further evaluations leveraging more comprehensive and standardized economic analyses across settings will be necessary. Clinical Trial: PROSPERO Registration No. CRD42022358616

Economic Evaluation Associated with Clinical-Grade Mobile Application-Based Digital Therapeutic Interventions: Systematic Review

In recent years, efficient methods for facilitation of intracellular drug delivery have become a prominent need within the modern biopharmaceutical industry. Targeting the delivery of a pharmacological substance to its intended physiological site of action ensures that adequate concentration of the therapeutics is made available, in order to elicit the desired clinical benefits and limit off-target / systemic toxicity. In fact, a study suggests that over 20% of the proteome, including oncogenic proteins, cell metabolism regulators, components of different signal transduction pathways and enzymes, is localized within the cell membrane. Further, considering the fact that only 10% of the human genome can selectively bind to small molecule pharmaceuticals, industry experts believe that intracellular biologics, particularly nucleic acid-based therapeutic interventions, present a promising alternative to conventional therapies. Furthermore, recent advancements in cell biology and intracellular delivery systems have led to the identification of several potential therapeutic targets for a variety of clinical disorders. These targets have been demonstrated to be capable of aiding the treatment of disease indications which were previously considered incurable, as they were localized within the confines of the cell membrane. It is also worth highlighting that majority of the available biopharmaceutical interventions, such as gene therapies, require cell membrane permeabilization in order to mediate their therapeutic effects. Gene delivery systems are usually based on viral and non-viral vectors and known to enable the entry of pharmacologically active compounds into the matrix of the cytoplasm. Specifically, viral drug delivery systems utilize the ability of viruses to inject their DNA inside host cells. However, such systems are often fraught with several challenges, such as immunogenicity, toxicity and reverse mutation. In order to overcome the aforementioned challenges and enable the delivery of intracellular biologics, researchers have developed various non-viral delivery systems, including exosome-based drug delivery techniques, cell-penetrating peptides (CPP) and nanoparticle-based processes. Further, numerous technology developers have signed several strategic agreements with therapy developers in order to facilitate the development of drug formulations that can be delivered to the intracellular matrix. Additionally, close to 1,300 patents related to such technologies have been filed / granted in the past few years, demonstrating the continued innovation being carried out in this domain. At present, more than 20,000 oligonucleotide-based therapeutics focused studies are being conducted across the globe. In this context, it is also worth mentioning that, recently, Novartis received the USFDA approval for Leqvio (inclisiran), a first-in-class siRNA therapy for lower LDL cholesterol, which is delivered using an intracellular drug delivery technology. Other examples of recently approved gene therapies that are being delivered intracellularly include (alphabetical order) ABECMA (idecabtagene vicleucel; manufactured by Celgene), BREYANZI (lisocabtagene maraleucel; manufactured by Juno Therapeutics) and KYMRIAH (tisagenlecleucel; manufactured by Novartis). Driven by a growing demand for systems that can efficiently deliver therapeutic interventions in intracellular spaces, the non-viral drug delivery systems market is likely to witness significant growth in the short to mid-term. Frequently Asked Questions
Which partnership models are commonly adopted by stakeholders engaged in this domain? What type of molecule can be delivered using intracellular drug delivery technologies? How is the intellectual property landscape related to intracellular drug delivery likely to evolve in the foreseen future? How is the current and future market opportunity likely to be distributed across key market segments and geographical region? Key Topics Covered:

Non-Viral / Intracellular Drug Delivery Systems Global Market Report 2022: Demand for Systems That Can Efficiently Deliver Therapeutic Interventions in Intracellular Spaces Bolsters Growth

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