Scientists have created a retrievable, wire-like device that safely resides in the stomach and releases large dosages of drugs over several weeks. The new delivery system, which was successfully tested in pigs, could help patients in remote and underserved geographic areas adhere to drug treatments for infectious diseases such as tuberculosis (TB) that are currently treated with burdensome amounts of oral medications. TB represents one of the most widespread and devastating infectious diseases today, causing approximately 10 million cases worldwide in 2017. Most cases of TB can be effectively treated with oral antibiotics, but most therapies involve multiple drugs administered in large doses for up to several months. (An average 60 kg patient requires 3.3 grams of antibiotics a day.) Following such treatment regimens can be challenging for patients (previous research reports that 50% of patients experience difficulty sticking to treatment recommendations), especially in developing regions that lack adequate healthcare resources. As a result, poor patient adherence to treatments has become a major contributor to treatment failure and the emergence of drug-resistant TB strains. To meet the need for a more practical delivery system, Malvika Verma and colleagues developed a new platform consisting of bead-like drug pills housed on a flexible wire that can be deployed to the stomach through the esophagus in 60 seconds. The researchers studied their device in healthy pigs and found that it safely released the standard TB antibiotics rifampicin over one week and doxycycline hyclate over four weeks, and was easily retrieved via a nasogastric tube after the treatment was completed. Importantly, a questionnaire of 111 TB health care providers and 300 patients with TB in India showed that a long-term nasogastric drug delivery system was considered feasible on the ground, and an established model predicted that such a device could result in over $8,000 in savings per patient.
Science Translational Medicine