Massachusetts Institute of Technology, Brigham, and Women’s Hospital researchers are developing a new capsule with the ability to deliver a week’s worth of HIV therapy drugs in a single dose. This pillbox in a capsule of sorts could advance current treatment methods and make it much more easier for patients to adhere to the strict scheduling of dosage required for the current drug cocktail used to fight the virus as published in Nature Communications.
The drugs will release gradually throughout the week in this capsule that was designed to be taken once a week by patients, then the capsules are designed to disintegrate into smaller components that will pass through the digestive tract after all of the drugs are released. Not only will this type of delivery system improve the ability to adhere to a treatment schedule, it will also be used by people who are at risk of HIV exposure to help prevent them from becoming infected according to the researchers.
Adherence is of great concern as a main barrier in treating and preventing HIV, less doses stands to improve this and make a significant impact. The drug delivery system can potentially help patients with AIDS/HIV as well as many other disease says Robert Langer and Giovanni Traverso.
There has been several clinical trials to try and determine if antiretroviral drugs could prevent HIV infection in healthy populations that have had mixed results with the major obstacle being adherence to the strict treatment schedule that is required every day. The BWH/MIT team believe that this drug capsule delivery system that they developed in 2016 may help address this issue. This new delivery system, the pill box in a capsule is a star shaped compartment structure with 6 arms that are folded inward after being loaded with drugs, encased in a smooth coating. After ingesting the arms will unfold gradually releasing their cargo.
Previous studies in which this capsule was tested in the gradual releasing the malaria drug ivermectin it was found that the capsules could remain in the stomach for up to 2 weeks, inspiring the researchers to adapt the capsule as a delivery system for the use of HIV drugs. Testing in pigs has shown that the capsule successfully stay in the stomach and released 3 different HIV drugs over the period of one week.
Predictive calculations made by the Institute for Disease Modeling predictively suggest that using this form of weekly treatment could improve the efficacy of HIV preventative treatments by approximately 20%. This calculation was then input into a computer model of HIV transmission in South Africa, when the calculation was added the model showed that between 200,00 to 800,000 new infections could be prevented over the next 20 years.
The overall mortality rate of HIV has dropped with the use of antiretroviral drugs were introduced, but the numbers are still high, in 2015 there were 1.2 million HIV related deaths and 2.1 million new HIV infections. Progress has been made in therapies enabling infected people to live longer lives to nearly a normal lifespan, adherence remains a challenge. Less invasive and longer lasting formulations are an important part of the future arsenal, the development of new and improved tools and approaches are needed to end the HIV pandemic.
