Star-shaped capsule: long-term drug dose

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A dose, tucked away in a capsule (left) and expanded (right).
Credit: Bellinger et al., Science Translational Medicine (2016)

Imagine if one pill could safely lodge itself in your intestine and systematically deliver a daily dose of your required medication for months on end.

That’s the projected reality of a new ultra-long-lasting drug delivery capsule, based on technology developed by researchers in the US and UK.

The capsule, described this week in Science Translational Medicine, encases a star-shaped structure that unfolds once it hits the stomach. Its size and shape prevent it from being passed through the gastrointestinal tract immediately.

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A schematic of the ingestible capsule unfurling and making its way into the small intestine, where it resides for weeks to months.
Credit: Bellinger et al., Science Translational Medicine (2016)

Instead, it takes up residence in the intestine, where it dispenses an allotment of medication in highly controlled dosages – a long-term treatment in one pill.

In this study, the research team tested this capsule successfully on pigs, reporting regular, two-week administration of medication without any harmful side-effects.

After treatment ended, the structure broke apart and passed through the digestive tract as normal.

Statistics from the World Health Organisation say just 50% of patients in developed countries adhere to their prescribed medication regime, and this creates a heavy financial burden on healthcare systems.

The new technology could have huge effects in all corners of healthcare, says Robert Langer, a chemical engineer at Massachusetts Institute of Technology in the US and senior author of the study.

“Until now, oral drugs would almost never last for more than a day,” he explains.

“This really opens the door to ultra-long-lasting oral systems, which could have an effect on all kinds of diseases, such as Alzheimer’s or mental health disorders. There are a lot of exciting things this could someday enable.”

The new study focuses on the technology’s applications in large-scale anti-malaria campaign, using a drug called ivermectin.

If a mosquito bites someone with ivermectin in their system, it dies, and researchers believe this could go a long way towards eliminating the deadly virus in regions where it thrives.

But ivermectin requires regular administration over a long period of time, which leaves a lot of room for human error.

“Getting patients to take medicine day after day after day is really challenging,” says Andrew Bellinger, co-author of the paper and a cardiologist at Brigham and Women’s Hospital in the US.

“If the medicine could be effective for a long period of time, you could radically improve the efficacy of your mass drug administration campaigns.”

The team is focused on patients with the most onerous medication regimes, including people with diabetes, HIV and epilepsy.

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