Wearable Microneedle Patches Move Toward Real-Time, Closed-Loop Drug Monitoring

A new generation of wearable microneedle patches is bringing continuous, real-time drug monitoring closer to clinical reality, with researchers at King Abdullah University of Science and Technology (搜索)搜索该词条 (KAUST) and UC San Diego (搜索)搜索该词条 demonstrating minimally invasive platforms that could one day both sense medicines inside the body and automatically deliver therapy in response.

In a study published in Device, KAUST researchers developed a wearable microneedle patch capable of continuously measuring drug levels beneath the skin and wirelessly transmitting the data to a smartphone in real time. The complete device weighs just 6.7 grams and combines microneedle sensing, electrochemical biosensors, onboard electronics, wireless communication and smartphone visualization into a single wearable system.

"Wearable technologies have changed the way people monitor many aspects of their health, from physical activity to heart rate and sleep. This research explores whether future wearable devices could also help us understand how medicines behave inside the body," said Khaled Nabil Salama, professor of Electrical and Computer Engineering and Bioengineering at KAUST and lead author of the study.

A Lab Under the Skin

The core of these efforts is a minimally invasive wearable sensing platform built around microneedles — tiny structures that can be designed as real-time biological sensors or as conduits for drug delivery. "We are developing a lab just under the skin," said Joseph Wang, DSC, Chemical and Nano Engineering Professor at UC San Diego (搜索)搜索该词条, whose lab has developed multiple microneedle designs over the last 15 years.

The sensing microneedles, each less than one millimeter in length, are designed to sense biomarkers or medicines of interest just beneath the surface of the skin, specifically in the body's dermal interstitial fluid. The microneedles currently in preliminary clinical trials at UC San Diego (搜索)搜索该词条 are solid microneedles coated with enzymes that bind to the biomarker or medicine of interest. The binding triggers an electrical signal that is recorded, with higher concentrations producing a larger signal.

Shallow Multiplex Sensing Without Pain

A key distinction from existing continuous glucose monitors is the depth of fluid sampled. The new systems access dermal interstitial fluid via microneedles less than 1 millimeter in length — shallower than pain nerves. This means that when microneedles pierce the outer layer of the skin, there is no pain and no feeling of a pin prick, just a bit of pressure. In contrast, continuous glucose monitors currently on the market measure interstitial fluid significantly deeper than 1 millimeter beneath the skin, relying on a larger guide needle that usually goes 5 to 6 millimeters into fatty tissue.

The platform is also designed for multiplexing. "Each microneedle is its own sensor, and on a centimeter square patch, there is room for many microneedles, each sensing a different biomarker or drug," explained Wang, who co-directs the Center for Wearable Sensors at the UC San Diego (搜索)搜索该词条 Jacobs School of Engineering.

Demonstrating Feasibility with Vancomycin

The KAUST team demonstrated the technology using vancomycin查看药品详情, an antibiotic commonly used to treat serious infections. Because the drug must be maintained within a relatively narrow concentration range to remain both safe and effective, it provides an ideal test case for technologies designed to continuously monitor medicines.

The researchers tested the platform in laboratory experiments and preclinical studies, where it successfully tracked changing drug concentrations over several hours. While further development and clinical validation will be required before the technology could be used in healthcare settings, the findings demonstrate the feasibility of continuous wearable drug monitoring using a minimally invasive sensor platform. Although demonstrated using an antibiotic, the researchers believe the sensing platform could potentially be adapted in the future for other medicines that require careful dose monitoring.

Clinical Validation in Parkinson's Disease

At UC San Diego (搜索)搜索该词条, Irene Litvan, MD, the Tasch Endowed Professor of Neurology and director of the school's Parkinson and Other Movement Disorders Center, is leading an ongoing pilot clinical trial in collaboration with Wang to test a minimally invasive, wearable sensor device that monitors levodopa查看药品详情 levels in real time.

Currently, levodopa查看药品详情 dosing adjustments are based on brief clinic assessments of the patient's condition, which may not accurately reflect fluctuating symptoms. Traditional methods of monitoring levodopa levels in blood plasma are costly, time-consuming and require centralized laboratory infrastructure, and are not used in clinical practice.

"Accurate, real-time drug monitoring could enhance the effectiveness of personalized management of Parkinson's disease (搜索)搜索该疾病," said Litvan. The clinical trial is evaluating the accuracy, tolerability and safety of the microneedle-based device in people with Parkinson's disease.

Early Sepsis Detection Through Continuous Lactate Monitoring

In a study published in 2026 in ACS Sensors, the researchers reported that wearable microneedle-based continuous lactate (搜索)搜索该靶点 sensors were highly accurate compared with standard blood tests for people in a variety of hospital settings, including an intensive care unit and an emergency department.

Rising lactate (搜索)搜索该靶点 levels signal a lack of oxygen in the blood, and reliable real-time measurements of lactate in interstitial fluid may help physicians detect early signs of sepsis (搜索)搜索该疾病 or shock, which can lead to better patient outcomes and potentially save lives. Recognizing early lactate rises is currently difficult because each check requires a separate blood draw, which can lead to anemia in patients, and frequent blood draws are uncomfortable and contribute to rising health care costs.

"The lactate (搜索)搜索该靶点 microneedle electrode has the strong potential to allow us to risk stratify patients in real time and to assess their responses to therapy. We are working toward an approach where we can use real-time lactate measurements to guide use of IV interventions to stabilize blood pressure and protect vital organs, eventually to individualize sepsis (搜索)搜索该疾病 therapy. The microneedle electrode is well tolerated and gives stable and accurate results in our studies to date," explained Atul Malhotra, MD, professor at the School of Medicine and research chief of Pulmonary, Critical Care, Sleep Medicine and Physiology at UC San Diego (搜索)搜索该词条 Health.

Toward Closed-Loop Sense-and-Treat Systems

The collaborative efforts are part of a larger goal to create an automated system that measures medication levels continuously and uses that information for automated medication delivery through the skin by way of microneedles. In future sense-and-treat systems, solid microneedles will perform sensing and work in concert with hollow microneedles that deliver medication stored in reservoirs outside the body into the interstitial fluid, from which the medicine enters the bloodstream.

Such closed-loop systems may improve quality of life for people with diabetes (搜索)搜索该疾病 and Parkinson's disease (搜索)搜索该疾病, and may help identify septic shock very early in people admitted to emergency rooms. As the KAUST team continues to develop its technology, future research will focus on extending monitoring duration, improving long-term stability and evaluating the platform across a broader range of medical applications.