Many of my friends refuse to take daily medication. Mostly because they fear they won’t be compliant and remember to take the pills as required. They are not alone- about ½ of all those prescribed meds screw things up. (About 125K deaths a year could be avoided if those folks took their meds.)
So, all kinds of toys exist. A 7 compartment box holder, apple watch timers, you name it. But, like birth control pills (which are notoriously not taken routinely- leading to many “surprise” babies) that have been obviated by an injectable that lasts 12 weeks (and some even last a year or two), the push has been on to develop medications that don’t require daily administration.
One such idea is being funded by the Gates Foundation, NIH, and the Max Planck Institute (Germany). The team doing the research (and conceived the concept) is from MIT and Brigham/Women’s Hospital (Harvard), headed by Dr. Bob Langer (MIT; I’ve written about my fellow chem e often) and Giovanni Traverso (Brigham-Women’s Hospital). The idea? A pill you take that releases medication over two- and, hopefully, more- weeks.
The criteria for long-term oral drug delivery means that the drug must be packaged in something that is capable of withstanding the acidic milieu of the stomach (plus its peristaltic actions)- and still release the drug over time, in a repeatable, predictable fashion. And, then, once the drug store is depleted, the capsule needs to be able to decompose and traverse the rest of the digestive tract, thereby being eliminated from the body.
That’s why the team [comprised of the following MIT folk: AM Bellinger, M Jafari, TM Grant, S Zhang, S Mo, Y-A L Lee, H Mazdiyasni, L Kogan, R Barman, C Cleveland, L Booth, T Bensel, D Minahan, HM Hurowitz, T Tai, plus Robert Langer and Giovanni Traverso (both of whom have joint appointments with Harvard-run hospitals); HC Slater (Imperial College, UK); EA Wenger, L Wood, PA Eckhoff (Institute for Disease Modeling, WA); J Daily (Albert Einstein, NY); and B Nikolic (Biomatics Capital, WA) ] designed a hexagonal shaped item, comprised of polycaprolactone (which is then encased in a smooth capsule). The hexagonal shape was chosen to maximize the pills ability to bounce around in one’s stomach. It turns out star-shaped objects are more resilient to the actions in the stomach, when compared to those of lattice and other geometries.
When the pill is ingested, the stomach acid (almost) immediately erodes the protective capsule, letting the arms of the hexagon expand to their full length. Once the pill is depleted of its drug stores, the arms dissolve (the drug is loaded into the six arms); that allows the pill remnant to pass through the pyloric sphincter.
The initial trials were described in Science Translational Medicine, Oral, ultra–long-lasting drug delivery: Application toward malaria elimination goals. These initial trials have been effected in pigs, with an antimalarial formulation (ivermectin) loaded into the capsule. That the formulation performed well for two weeks is pretty amazing, since pigs ‘enjoy’ a much more fibrous diet than humans (banana peels and yams [uncooked] are normal diet components).
Not atypical for Bob Langer, a new company has been formed to complete the development- and the marketing- of the formulation. Lyndra (based in Cambridge, MA) will be focusing on maladies that can benefit from slow-release, sustained drug delivery, such as HIV/AIDS, diabetes, neuropsychiatric ailments, and epilepsy.
One interesting question? What will the pill do if the subject begins to vomit? But, the primary issue is still to control the release rate to be consistent over two weeks or more.
This is fascinating! I take quite a few supplements and am pretty good about remembering to take them daily—-but it sure would be nice to only have to have an injectable every 12 weeks!
An injectable every dozen weeks is already out for many drugs. This would be an ingestible one, Marcia…
But, every little bit helps. Because the older we get, the more forgetful we become.
Interesting – I take the pill though have put myself on a schedule where I take it every evening before bed, that way I always remember to take it on time. I don’t know why, but I never liked the idea of injections or implants that last for months to even years, I have friends who swear by them, so it’s definitely a personal thing, I like taking it so I control what I take day by day 🙂
I dunno, Megan. I’m betting you took a slew of injections to preclude you succumbing to polio, measles, mumps, etc. They last for years- and that’s the goal of most preventive measures. One and done is so much better than relying on our ability to follow a daily regimen.
But, I’m certainly glad you do- and it works for you.
This would be a blessing for my elderly mother in law, who is on a lot of pills – how can anyone remember? I don’t know if I could! I might go for a once a week pill. Longer than that, I’d be less sure about. You still have the rhythm of needing to take the pill with a once a week i.e. you know to take it every Sunday (or whatever).
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I agree that replacing a lot of pills with fewer would be nice. But, I’m guessing the replacement- at least, initially- will be for those drugs that have relatively high cost and require regular dose. The old cost-benefit cycle to justify the adoption of a new technology.
Hmmm, interesting point about people forgetting to take their medication. I would hope that these super pills wouldn’t lead to people have toxic levels of medication in their system.
That’s why these pills are all slow release formulations. Because they need to deliver a set dose each and every day- or the pill is worthless, Alice.