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Drug-releasing coil in stomach could provide better treatment for TB

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A simpler way to treat TB?

Malvika Verma and Karan Vishwanath

If you hate taking pills, you might be excited by the invention of a coil that sits in the stomach slowly releasing medication over weeks.

This could play a major role in reducing deadly tuberculosis infections and the rapidly growing problem of antimicrobial resistance, says the device’s developer Malvika Verma of the Massachusetts Institute of Technology.

Once fully coiled, the device is 10 centimetres long and threaded with pills. “You have a hole in the pill, kind of like a candy necklace, and each pill can be a different drug,” says Verma.

The coil can be unfurled to deliver it to the stomach via the nose and throat, where it springs back into a coil again. This coil is too large to leave the stomach, so it stays there, and the medicines threaded onto it leach out at a rate depending on the type of drug and the polymer the developers use to make the pills.

After the drugs have dissolved away, the device can be retrieved via the nose and throat using a magnet attached to the coil.

Pig tests

Verma and her team decided to test how well the device would work delivering antibiotics to pigs. Over the course of a month, blood tests revealed the coil was steadily dispensing the medication into the body, and pigs suffered no apparent side effects such as weight loss, issues passing food or liquids or stomach injury.

They chose to trial the device with the kind of antibiotics used to treat TB because the condition requires people to take multiple tablets every day. For many patients, particularly those in remote areas, sticking to such a regime can be quite difficult.

Yet failing to do so contributes to the evolution of drug-resistant TB strains, and these are expected to account for one in four drug-resistant related deaths by 2050.

Verma and her team are hoping to perform the first human trial of the system within the next five years.

The device wouldn’t only be useful for conditions that need many pills per day to successfully treat. It could also help patients who are forgetful, or have conditions that interfere with reliable self-management, such as dementia or schizophrenia.

Journal reference: Science Translational Medicine, DOI: 10.1126/scitranslmed.aau6267

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