Experimental drugs for the inhibition of preterm labour.

Introduction : Preterm birth is the leading cause of neonatal morbidity and mortality globally and poses a substantial economic burden. Consequently, there is a need for the identification of therapeutic targets and novel experimental drugs for the inhibition of preterm labour to improve neonatal outcomes. Areas covered : The authors review the pathophysiology of labour and the inflammatory pathways underpinning it. The interruption of these pathways forms the basis of therapeutic targets to inhibit preterm labour. Current drugs available for the treatment of preterm labour are reviewed, followed by experimental drugs; this includes toll-like receptor 4 (TLR-4) antagonists, cytokine suppressive anti-inflammatory drugs (CSAIDs), N-acetyl cysteine (NAC), Sulfasalazine (SSZ), tumour necrosis factor alpha (TNF-α) antagonists, interleukin-1 receptor (IL-1) inhibitors, omega-3 polyunsaturated fatty acids and lipid metabolites, and the polyphenols. Expert Opinion : The drive to develop therapeutic strategies for the prevention of preterm labour is constantly evolving, hence significant opportunities for the improvement of survival and neurodevelopmental outcomes for babies born preterm and the reduction of healthcare burden now exist. Numerous therapeutics are being explored for their potential in preterm birth prevention, and it is likely that over the next decade there will be a new treatment option that targets the pathological inflammatory processes involved in preterm labour.