Advances in Transdermal Drug Delivery Systems for Antithrombotic Therapy: A Systematic Review.

Thrombotic diseases, classified as arterial or venous, remain one of the most important global health concerns. Myocardial infarction, ischemic stroke, and venous thromboembolism (VTE), which include deep vein thrombosis and pulmonary embolism, are prominent causes of illness and death. Antithrombotic agents, classified by their sites of action, are essential for preventing and treating thrombus formation. Transdermal drug delivery systems have emerged as promising alternatives for antithrombotic therapy by improving drug bioavailability, patient adherence, and therapeutic efficacy while reducing side effects. This systematic review, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, identified 25 relevant articles through structured database searches. An additional search in clinical trial registries revealed no ongoing or completed clinical studies involving transdermal antithrombotic therapy. The literature focuses on transdermal formulations of heparins and acetylsalicylic acid, with fewer reports on direct oral anticoagulants and other agents. The literature search revealed that the most investigated delivery systems were microneedles (13), micro/nanoemulsions (2), ethosomes (1), hydrogels (5), polymeric patches (3), and liposomes (1). The ongoing interest in antithrombotic transdermal formulations highlights both their therapeutic importance and the difficulties still associated with traditional administration methods. While innovative transdermal formulations show promise, further research is necessary to develop scalable, effective, and cost-efficient technologies for clinical applications.