Long Acting Ivermectin Could Offer Protection for Weeks Against Malaria

Highlights

• Ultralong-acting pill delivers malaria drug for 14 days
• Non-adherence to medication is a long standing worry for the medical community in controlling spread of infectious diseases and in psychiatric illnesses
• Long acting ivermectin pill will remove the need for daily medication and provide the right dosage for weeks, months or more.

Researchers from Brigham and Women’s hospital along with collaborators from Massachusetts Institute of Technology have developed a long acting drug that will deliver the required amount of medication for weeks, month or more. This wonder drug promises to provide a better method of medication, greatly reducing the need for daily medication. The team of researchers tested the efficacy of the drug and its ability to deliver medication using both mathematical models as well as large animal models. For the purpose of the study, ivermectin, a drug used in the treatment of parasitic infections including river blindness was used. The drug also helped in keeping mosquitoes that carried malaria at bay.

Gastroenterologist and biomedical engineer in the Division of Gastroenterology at BWH and an instructor of medicine at Harvard Medical School, Dr. Giovanni Traverso said "We want to make it as easy as possible for people to take their medications over a sustained period of time. When patients have to remember to take a drug everyday or multiple times a day, we start to see less and less adherence to the regimen. Being able to swallow a capsule once a week or once a month could change the way we think about delivering medications."

Non- Adherence to Medication

Medications need to be taken for a prescribed period of time to help cure the patient and non- adherence can interfere with the course of treatment.

• Studies show that 30 to 60% do not adhere to medications. Non-adherence is especially high when there are no symptoms exhibited.
• 77% of patients were found to adhere to a medication schedule when it was to cure a disease
• 63% of patients adhered to medication when it was for prevention.
• Only 50% of patients adhered to long term compliance for medication, whether it was for prevention or cure.
• 20 to 80% of patients make errors while taking medications
• 20 to 60% stop medications even before they ought to
• Patients are also known to mix medications, which can be potentially fatal
• In the U.S, non-adherence leads to 100 billion dollars in expenditure.
• In poor resource settings, there may not be the availability of a lot of medication to last a course
• Patients may be unwilling to travel long distances for medications every time, this is especially true in rural areas.

The problems that are caused due to non-adherence and the need to find a solution prompted these researchers to develop a drug that is slowly released into the system, over a period of time. The co-first author of the study Dr. Andrew Bellinger said "In addition to improving adherence, our ultra long-acting drug delivery system may reduce side effects and improve drug efficacy by smoothing out the high variability of serum concentration that often comes with taking a daily pill." Dr Andrew is the Chief Scientific Officer at Lydra, the company that has licensed the technology from Brigham and Women’s Hospital and MIT and is developing the same for commercial use.

The Long Acting Drug

The drug is the size of a fish oil capsule which turns star shaped when consumed and gets lodged in the digestive system. It is too big to be removed from the pylorus of the stomach. The drug does not prevent food to move through this system.

The drug consists of polymers and other material that are designed to keep the drug in the system for longer periods of time.

Dr Traverso further added, "The gastrointestinal tract is a strong, durable passage way through the body. We designed the capsule to pause its transit in the stomach to allow for more controlled drug delivery and absorption, before passing through the gastrointestinal tract without any harm. Some of the challenges we face in getting the capsule in place are the 'ship in the bottle problem' - in this case, the neck of the bottle is the esophagus - and preventing the capsule from passing through the rest of the tube. The pylorus is about 2 centimeters in diameter so we designed our system to be 4 centimeters when it opens."

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Ivermectin is a drug that is used for river blindness and other parasitic infections. The presence of the drug in the blood kills mosquitoes, which prevents the spread of malaria. Currently the researchers have been able to maintain the drug in the body for about 2 weeks, however, they would like to increase the duration to about one month.

The drug is being developed for psychiatric illnesses, infectious diseases like HIV, heart diseases and renal diseases. The potential use of this drug in supporting patients who may not be in the right frame of mind or with the required mental capability to follow a regimen like in psychiatric ailments, may be a concrete step forward towards better medical care.

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References:

1. Definitions, Variants and Causes of Nonadherence with Medication: A Challenge for Tailored Interventions - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3711878/)

Source-Medindia