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Biskupiak Z, Ha VV, Rohaj A, Bulaj G. Digital Therapeutics for Improving Effectiveness of Pharmaceutical Drugs and Biological Products: Preclinical and Clinical Studies Supporting Development of Drug + Digital Combination Therapies for Chronic Diseases. J Clin Med 2024; 13:403. [PMID: 38256537 PMCID: PMC10816409 DOI: 10.3390/jcm13020403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Limitations of pharmaceutical drugs and biologics for chronic diseases (e.g., medication non-adherence, adverse effects, toxicity, or inadequate efficacy) can be mitigated by mobile medical apps, known as digital therapeutics (DTx). Authorization of adjunct DTx by the US Food and Drug Administration and draft guidelines on "prescription drug use-related software" illustrate opportunities to create drug + digital combination therapies, ultimately leading towards drug-device combination products (DTx has a status of medical devices). Digital interventions (mobile, web-based, virtual reality, and video game applications) demonstrate clinically meaningful benefits for people living with Alzheimer's disease, dementia, rheumatoid arthritis, cancer, chronic pain, epilepsy, depression, and anxiety. In the respective animal disease models, preclinical studies on environmental enrichment and other non-pharmacological modalities (physical activity, social interactions, learning, and music) as surrogates for DTx "active ingredients" also show improved outcomes. In this narrative review, we discuss how drug + digital combination therapies can impact translational research, drug discovery and development, generic drug repurposing, and gene therapies. Market-driven incentives to create drug-device combination products are illustrated by Humira® (adalimumab) facing a "patent-cliff" competition with cheaper and more effective biosimilars seamlessly integrated with DTx. In conclusion, pharma and biotech companies, patients, and healthcare professionals will benefit from accelerating integration of digital interventions with pharmacotherapies.
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Affiliation(s)
- Zack Biskupiak
- Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA
| | - Victor Vinh Ha
- Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA
| | - Aarushi Rohaj
- Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA
- The Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT 84113, USA
| | - Grzegorz Bulaj
- Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA
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Otis C, Bouet E, Keita-Alassane S, Frezier M, Delsart A, Guillot M, Bédard A, Pelletier JP, Martel-Pelletier J, Lussier B, Beaudry F, Troncy E. Face and Predictive Validity of MI-RAT ( Montreal Induction of Rat Arthritis Testing), a Surgical Model of Osteoarthritis Pain in Rodents Combined with Calibrated Exercise. Int J Mol Sci 2023; 24:16341. [PMID: 38003530 PMCID: PMC10671647 DOI: 10.3390/ijms242216341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/02/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
Validating animal pain models is crucial to enhancing translational research and response to pharmacological treatment. This study investigated the effects of a calibrated slight exercise protocol alone or combined with multimodal analgesia on sensory sensitivity, neuroproteomics, and joint structural components in the MI-RAT model. Joint instability was induced surgically on day (D) 0 in female rats (N = 48) distributed into sedentary-placebo, exercise-placebo, sedentary-positive analgesic (PA), and exercise-PA groups. Daily analgesic treatment (D3-D56) included pregabalin and carprofen. Quantitative sensory testing was achieved temporally (D-1, D7, D21, D56), while cartilage alteration (modified Mankin's score (mMs)) and targeted spinal pain neuropeptide were quantified upon sacrifice. Compared with the sedentary-placebo (presenting allodynia from D7), the exercise-placebo group showed an increase in sensitivity threshold (p < 0.04 on D7, D21, and D56). PA treatment was efficient on D56 (p = 0.001) and presented a synergic anti-allodynic effect with exercise from D21 to D56 (p < 0.0001). Histological assessment demonstrated a detrimental influence of exercise (mMs = 33.3%) compared with sedentary counterparts (mMs = 12.0%; p < 0.001), with more mature transformations. Spinal neuropeptide concentration was correlated with sensory sensitization and modulation sites (inflammation and endogenous inhibitory control) of the forced mobility effect. The surgical MI-RAT OA model coupled with calibrated slight exercise demonstrated face and predictive validity, an assurance of higher clinical translatability.
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Affiliation(s)
- Colombe Otis
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (C.O.); (E.B.); (S.K.-A.); (M.F.); (A.D.); (M.G.); (B.L.); (F.B.)
| | - Emilie Bouet
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (C.O.); (E.B.); (S.K.-A.); (M.F.); (A.D.); (M.G.); (B.L.); (F.B.)
| | - Sokhna Keita-Alassane
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (C.O.); (E.B.); (S.K.-A.); (M.F.); (A.D.); (M.G.); (B.L.); (F.B.)
| | - Marilyn Frezier
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (C.O.); (E.B.); (S.K.-A.); (M.F.); (A.D.); (M.G.); (B.L.); (F.B.)
| | - Aliénor Delsart
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (C.O.); (E.B.); (S.K.-A.); (M.F.); (A.D.); (M.G.); (B.L.); (F.B.)
| | - Martin Guillot
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (C.O.); (E.B.); (S.K.-A.); (M.F.); (A.D.); (M.G.); (B.L.); (F.B.)
| | - Agathe Bédard
- Charles River Laboratories Montreal ULC, Senneville, QC H9X 1C1, Canada;
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, Université de Montréal Hospital Research Center (CRCHUM), Montréal, QC H2X 0A9, Canada; (J.-P.P.); (J.M.-P.)
| | - Johanne Martel-Pelletier
- Osteoarthritis Research Unit, Université de Montréal Hospital Research Center (CRCHUM), Montréal, QC H2X 0A9, Canada; (J.-P.P.); (J.M.-P.)
| | - Bertrand Lussier
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (C.O.); (E.B.); (S.K.-A.); (M.F.); (A.D.); (M.G.); (B.L.); (F.B.)
- Osteoarthritis Research Unit, Université de Montréal Hospital Research Center (CRCHUM), Montréal, QC H2X 0A9, Canada; (J.-P.P.); (J.M.-P.)
| | - Francis Beaudry
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (C.O.); (E.B.); (S.K.-A.); (M.F.); (A.D.); (M.G.); (B.L.); (F.B.)
- Osteoarthritis Research Unit, Université de Montréal Hospital Research Center (CRCHUM), Montréal, QC H2X 0A9, Canada; (J.-P.P.); (J.M.-P.)
- Centre de Recherche sur le Cerveau et L’Apprentissage (CIRCA), Université de Montréal, Montréal, QC H3T 1P1, Canada
| | - Eric Troncy
- Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Department of Biomedical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC J2S 2M2, Canada; (C.O.); (E.B.); (S.K.-A.); (M.F.); (A.D.); (M.G.); (B.L.); (F.B.)
- Osteoarthritis Research Unit, Université de Montréal Hospital Research Center (CRCHUM), Montréal, QC H2X 0A9, Canada; (J.-P.P.); (J.M.-P.)
- Centre de Recherche sur le Cerveau et L’Apprentissage (CIRCA), Université de Montréal, Montréal, QC H3T 1P1, Canada
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