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Repeated IM injections are painful and inconvenient, and other local side effects such as tissue irritation or fibrosis at injection sites are also concerns, leading to low long-term patient compliance ( 4.4 Intrathecal administration Intrathecal (IT) delivery involves administering the chelator directly into the CSF (often via lumbar puncture or an implanted reservoir), thereby bypassing the BBB ( Molecules administered by intrathecal administration still encounter barriers within the subarachnoid space for drug penetration from CSF into brain parenchyma, but IT dosing creates a favorable concentration gradient for drugs to diffuse

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