Choline geranate (CAGE): A multifaceted ionic liquid for drug delivery

Ionic liquids, organic salts in a liquid state below 100 °C, have traditionally been associated with industrial applications. Recent research has introduced a new generation of ionic liquids, designed from biocompatible ions, to enable applications in drug delivery. Here, I provide a historical perspective, development status and applications of a leading example of biocompatible ionic liquids, a salt of Choline And Geranic acid (CAGE). Since its first report in 2014, CAGE has opened multiple drug delivery applications including transdermal, oral, buccal, sustained release, tissue ablation, periodontitis and hand hygiene, among others. CAGE-based products have been tested in more than 200 patients through multiple Phase 1 and Phase 2 clinical studies, including successful use in a Phase 2 clinical study in Atopic Dermatitis patients. CAGE became the first 'drug delivery ionic liquid' to enter into clinical trials. This article summarizes the key fundamental and translational aspects of CAGE as pertained to its use in drug delivery.