ReportDrug Delivery

A gastric resident drug delivery system for prolonged gram-level dosing of tuberculosis treatment

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Science Translational Medicine  13 Mar 2019:
Vol. 11, Issue 483, eaau6267
DOI: 10.1126/scitranslmed.aau6267

Dependable drug delivery

Although Mycobacterium tuberculosis (TB) infections are effectively treated with antibiotics, treatment requiring multigram dosing can pose considerable challenges for patients in resource-constrained environments. Here, Verma et al. developed a drug delivery system that is compatible with nasogastric administration consisting of bead-like drug pills on a shape memory wire that resides in the stomach for long-term, multigram dosing. The device was administered to healthy pigs where it demonstrated safe, sustained antibiotic release within the stomach over weeks; it was also easily retrieved from the stomach when drug delivery was complete. The authors suggest that this device could improve patients’ adherence to treatment regimens.

Abstract

Multigram drug depot systems for extended drug release could transform our capacity to effectively treat patients across a myriad of diseases. For example, tuberculosis (TB) requires multimonth courses of daily multigram doses for treatment. To address the challenge of prolonged dosing for regimens requiring multigram drug dosing, we developed a gastric resident system delivered through the nasogastric route that was capable of safely encapsulating and releasing grams of antibiotics over a period of weeks. Initial preclinical safety and drug release were demonstrated in a swine model with a panel of TB antibiotics. We anticipate multiple applications in the field of infectious diseases, as well as for other indications where multigram depots could impart meaningful benefits to patients, helping maximize adherence to their medication.

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