Biopharmaceuticals against substance use disorders - Present and future

Area of Science:

• Biotechnology
• Pharmacology
• Neuroscience

Background:

• Current pharmacological treatments for substance use disorder (SUD) primarily use pharmacodynamics, targeting drug-of-abuse (DOA) receptors.
• These traditional methods have limitations, including patient compliance issues, off-target effects, perpetuating addiction, and limited applicability to many DOAs.
• There is a need for pharmacokinetic approaches that limit brain access of DOAs or reverse addiction-related brain changes.

Purpose of the Study:

• To review the literature on biopharmaceutical developments for treating SUD.
• To explore novel pharmacokinetic strategies as alternatives to traditional pharmacodynamic treatments for SUD.

Main Methods:

• Literature review of biopharmaceuticals developed for SUD treatment.
• Examination of active and passive immunization, metabolic enhancers, and genetic/epigenetic modulation.

Main Results:

• Biopharmaceutical strategies like active/passive immunization, metabolic enhancers, and genetic/epigenetic modulation are promising for next-generation SUD treatments.
• Active immunization involves vaccination to produce antidrug antibodies; passive immunization uses exogenous antibody administration.
• Metabolic enhancers augment DOA metabolism and clearance, while nanotechnological advances enable brain delivery of genetic material (siRNA, mRNA, DNA) to modulate addiction pathways.

Conclusions:

• Biopharmaceuticals hold potential to complement or replace traditional pharmacodynamic SUD treatments.
• Passive and active immunization biopharmaceuticals are in human clinical trials.
• Metabolic enhancers and genetic approaches are currently in the preclinical stages of development.