Optimizing deferoxamine delivery through the skin for pressure ulcers.

INTRODUCTION: Deferoxamine (DFO) is an iron-chelator, approved for systemic treatment of iron overload. New research finds local applications to mechanistically correct ischemia-driven hypoxia that underlies chronic wound pathology resulting in therapeutic angiogenesis. Development of composite hydrogels and hybrid biomaterials that combine natural and synthetic polymers for enhanced mechanical integrity, antimicrobial function, and controlled drug release confirms that the field is moving toward multifunctional, bio-responsive wound therapies. Incorporating deferoxamine via reverse-micelle technology in a Deferoxamine Intradermal Delivery Patch (DIDP) advances this field by integrating a clinically approved, mechanistically targeted drug within a biocompatible matrix supported by preclinical safety and translational feasibility.

AREAS COVERED: We review transdermal application of deferoxamine and current biomaterials that enable dermal penetration of hydrophilic drugs. We discuss the first-ever in-human clinical application of DIDP and scarcity of clinical trials. Furthermore, we outline necessary steps for broad implementation of DIDP and explore potential future applications, including combination therapies.

EXPERT OPINION: Deferoxamine provides a remarkable ability to induce therapeutic angiogenesis despite diabetes or increased age, and this therapy could be utilized for other diseases that impair wound healing such as autonomic skin dysfunction following complete spinal cord injury. We identify efforts to increase the long-term safety profiles and advocate for large-scale randomized clinical trials.