Drug delivery device could transform TB treatment

A new device developed by researchers at the Massachusetts Institute of Technology (MIT) could transform the way drugs for tuberculosis (TB) are delivered into the body.

As one of the world’s deadliest diseases, TB kills over 1 million people every year, and it’s thought that over a quarter of the world’s population are infected with the disease.

Treating TB requires patients to take a six-month course of daily antibiotics, something which is difficult for patients to adhere to, especially those in rural areas with limited access to medical facilities.

Now, researchers at MIT have developed a new way to deliver antibiotics in an effort to reduce healthcare costs and cure more patients.

The device consists of a coiled wire loaded with antibiotics which is inserted into the patient’s stomach through a nasogastric tube. Once in the stomach, the device slowly releases antibiotics over one month, eliminating the need for patients to take pills every day.

“Having a system that allows you to ensure the patient receives the full treatment course could be really transformational,” says Giovanni Traverso, an assistant professor in MIT’s Department of Mechanical Engineering and a gastroenterologist at Brigham and Women’s Hospital. “When you consider the situation with tuberculosis, where you have multiple grams of antibiotics that have to be taken every day, for many months, we need another solution.”

The team’s device is made of nitinol; an alloy of nickel and titanium that can change its shape based on temperature. The researchers say they can string up to 600 various antibiotics along the wire which can be tuned to control the rate of drug release once the device enters the stomach.

Once in the stomach, the wire transforms into a coil to prevent in passing further through the digestive system.

During tests in pigs, the team found that their prototype device could release several different antibiotics at a constant rate for 28 days.

The team said that this method was preferred by patients, who could come to a healthcare setting every few weeks instead of being seen by a healthcare provider every day.

The research team included economist David Collins of Boston University who suggested that if implemented in India, treatment costs could be reduced by about $8,000 per patient.

“The current model for TB treatment is directly observed treatment, short course, where the patients have to come in every day and have somebody watch them take their pills. That’s a huge burden, for the patients and the healthcare system,” said Malvika Verma the study’s lead author. “We envision this as utilising the infrastructure of the directly observed treatment, but reducing the frequency of administering the treatment from daily to monthly.”

The device could also prove useful for patients with hepatitis C, which requires treatment with antiviral drugs for two to six months, as well as many other infectious disease.

“In many situations, patients need to take multigram dosages of a drug, but up until now, this has been very difficult to do,” Langer says. “We believe that this new approach is an important milestone toward addressing this problem.”

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