Modern medicine has meant that HIV is easily treatable, with many sufferers going on to lead long and healthy lives. So non-invasive is treatment that some even compare its medical upkeep with that of asthma. Predictably, there are nuances to this picture, with rigorous courses of medication causing non-adherence among patients. Indeed, studies show that less than a third of patients stick to their dosage plans in HIV clinical trials, a pattern which makes it difficult to collate accurate data.
This could soon be a problem of the past, thanks to researchers at Brigham and Women’s Hospital and the Massachusetts Institute of Technology (MIT), who have devised an ingestible “mini pill box” that, once inside the body, can dispense medicine internally.
The study, published in the journal Nature Communications, could serve to combat the non-adherence among those undergoing treatment for HIV; in providing long-lasting doses of medication once a week, the pill box would reduce the arduous upkeep of daily pill-taking.
The efficacy of the newly engineered product was attested to by Dr Giovanni Traverso, a – deep intake of breath – gastroenterologist and biomedical engineer in the Division of Gastroenterology at BWH and an Assistant Professor of Medicine at Harvard Medical School. “These slow-release dosage systems perform equal or better than the current daily doses for HIV treatment in preclinical models,” explained Dr Traverso.
The “pill box” in question is an ameliorated preclinical version of a capsule the team produced in 2016 – a design which internally unfurled into a star-shape structure comprised of polymers that would let drugs diffuse into the body over time. That’s one hell of a party trick.
The improved-upon version can hold multiple drugs at once, with each of its six arms designated for a particular drug. What’s more, researchers used mathematical modelling to foresee what happens when in instances of missed doses – with exciting discoveries. Not only did the findings reveal that the new system could reduce therapeutic failures, but also that it could actively prevent thousands of new HIV cases.
In converting doses from a daily intake to a weekly intake, the new system could improve the results of pre-exposure HIV prevention strategies by up to 20%. When applied to the context of South Africa, projections showed that between 200,000 and 800,000 new infections over the next 20 years could be prevented.
The next step for the team is to validate the preclinical models, evolving the findings into a potential therapy for patients. We spoke with Dr Traverso, who explained that the company is working with Lyndra, “a biotechnology company focused on the development of oral, ultra long-acting, sustained release therapies to drastically improve adherence and efficacy, who are working on human application.” Excitingly, the team anticipates that initial trials will be completed in the next 12-24 months.
Could the system be used to combat other infectious diseases, we wonder? Dr Traverso revealed to Alphr that the researchers are “developing dosage forms with the capacity to provide orally-delivered ultra-long drug delivery several diseases including: malaria, HIV, tuberculosis, and several neglected tropical diseases.” Lyndra in particular, he explained, focuses on therapeutic areas where “improved compliance and pharmacokinetic benefits significantly improve patient outcome,” including HIV, malaria and neuropsychiatric diseases such as Alzheimer’s, among others.
In the meantime, doctors everywhere remain staunch that as far as swallowing inedible objects go, this is very much the exception to the rule….
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