Reducing Burden Of Tuberculosis

Anne Trafton | MIT News Office

March 13, 2019

Tuberculosis is one of the world’s deadliest infectious diseases: One-third of the world’s population is infected with TB, and more than 1 million people die from the disease every year.

One reason TB is so pervasive is that treatment requires a six-month course of daily antibiotics, which is difficult for about half of all patients to adhere to, especially in rural areas with limited access to medical facilities. To help overcome that, a team of researchers led by MIT has devised a new way to deliver antibiotics. Using this new approach, a coiled wire loaded with antibiotics 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.The paper’s lead author is MIT graduate student Malvika Verma.

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Long-term delivery

One of their capsules has shown promise for delivering small amounts of drugs to treat HIV and malaria. After being swallowed, the capsule’s outer coating dissolves, allowing six arms to expand, helping the device to lodge in the stomach. This device can carry about 300 milligrams of drugs — enough for a week’s worth of HIV treatment, for example.The new device is a thin, elastic wire made of nitinol — an alloy of nickel and titanium that can change its shape based on temperature. The researchers can string up to 600 “pills” of various antibiotics along the wire, and the drugs are packaged in polymers whose composition can be tuned to control the rate of drug release once the device enters the stomach.The wire is delivered to the patient’s stomach via a tube inserted through the nose, which is used routinely in hospitals for delivering medications and nutrients. As part of their study, the researchers interviewed 300 tuberculosis patients in India, and most said that this kind of delivery would be acceptable to them for long-term treatment. Once the wire reaches the higher temperatures of the stomach, it forms a coil, which prevents it from passing further through the digestive system.

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Cost Reduction

The research team included an economist, David Collins of Boston University, who analyzed the potential economic impact of this type of treatment. He found that if implemented in India, treatment costs could be reduced by about $8,000 per patient.

Source : http://news.mit.edu/2019/stomach-device-antibiotics-tuberculosis-0313