- Title
- Landscape of preterm birth therapeutics and a path forward
- Creator
- Coler, Brahm Seymour; Shynlova, Oksana; Boros-Rausch, Adam; Lye, Stephen; McCartney, Stephen; Leimert, Kelycia B.; Xu, Wendy; Chemtob, Sylvain; Olson, David; Li, Miranda; Huebner, Emily; Curtin, Anna; Kachikis, Alisa; Savitsky, Leah; Paul, Jonathan W.; Smith, Roger; Waldorf, Kristina M. Adams
- Relation
- Journal of Clinical Medicine Vol. 10, Issue 13, no. 2912
- Publisher Link
- http://dx.doi.org/10.3390/jcm10132912
- Publisher
- MDPI AG
- Resource Type
- journal article
- Date
- 2021
- Description
- Preterm birth (PTB) remains the leading cause of infant morbidity and mortality. Despite 50 years of research, therapeutic options are limited and many lack clear efficacy. Tocolytic agents are drugs that briefly delay PTB, typically to allow antenatal corticosteroid administration for accelerating fetal lung maturity or to transfer patients to high-level care facilities. Globally, there is an unmet need for better tocolytic agents, particularly in low- and middle-income countries. Although most tocolytics, such as betamimetics and indomethacin, suppress downstream mediators of the parturition pathway, newer therapeutics are being designed to selectively target inflammatory checkpoints with the goal of providing broader and more effective tocolysis. However, the relatively small market for new PTB therapeutics and formidable regulatory hurdles have led to minimal pharmaceutical interest and a stagnant drug pipeline. In this review, we present the current landscape of PTB therapeutics, assessing the history of drug development, mechanisms of action, adverse effects, and the updated literature on drug efficacy. We also review the regulatory hurdles and other obstacles impairing novel tocolytic development. Ultimately, we present possible steps to expedite drug development and meet the growing need for effective preterm birth therapeutics.
- Subject
- tocolytic; preterm birth; preterm labor; neonate; prematurity; pregnancy; therapeutic; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1458580
- Identifier
- uon:45462
- Identifier
- ISSN:2077-0383
- Rights
- © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
- Language
- eng
- Full Text
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