Current trends in needle-free jet injection: an update

Daniel Barolet,1,2 Antranik Benohanian3 1RoseLab Skin Optics Research Laboratory, Laval, QC, Canada; 2MUHC Dermatology Service, Department of Medicine, McGill University, Montreal, QC, Canada; 3CHUM Service de Dermatologie, Université de Montréal, Montréal, QC, Canada Background: Jet injection can be defined as a needle-free drug delivery method in which a high-speed stream of fluid impacts the skin and delivers a drug. Despite 75 years of existence, it never reached its full potential as a strategic tool to deliver medications through the skin. Objective: The aim of this review was to evaluate and summarize the evolution of jet injection intradermal drug delivery method including technological advancements and new indications for use. Methods: A review of the literature was performed with no limits placed on publication date. Results: Needleless injectors not only reduce pain during drug delivery but also confine the drug more evenly in the dermis. Understanding skin properties of the injection site is a key factor to obtain optimal results as well as setting the right parameters of the jet injector. Until the advent of disposable jet injectors/cartridges, autoclaving of the injector remains the only reliable method to eliminate the risk of infection. Needle-free intradermal injection using corticosteroids and/or local anesthetics is well documented with promising indications being developed. Limitations: Limitations of the review include low-quality evidence, small sample sizes, varying treatment parameters, and publication bias. Conclusion: New developments may help reconsider the use of jet injection technology. Future studies should focus on measurable optimized parameters to insure a safe and effective outcome. Keywords: needle free, injector, jet injection, xylocaine, triamcinolone, PD