Chronic diseases, such as rheumatoid arthritis, heart diseases and diabetes, require lifelong medication. Varying doses of medications have to be administered at specific times of the day depending on the requirements of the patient. The treatment of these persistent ailments gets compromised when patients cannot comply with the strict dosage schedule due to practical problems. It is especially difficult for patients to take oral medications during the night thereby compromising the therapeutic efficacy and safety. Individual patients require personalized treatment thus a single approach to tackle the problem of missed doses is not possible. Researchers are constantly trying to develop an individualized precise treatment for scheduled dosage of medications.
Researchers from Houston Methodist have developed a subcutaneously (under the skin) implantable grape-sized device for sustained drug release with adjustable dosage and timing. Using the implant they have efficiently and effectively administered continuous and predetermined doses of drugs for the treatment of two chronic diseases. This nanochannel delivery system (nDS) is remotely controlled by Bluetooth to regulate the delivery of drugs for the treatment of chronic diseases. According to the research team the nDS can administer regulated doses of drugs for up to a year independent of any pump or valve. In certain cases the implant is even capable of delivering drugs without a refill for up to a year. The ingenious work by the team has been published in Lab on a Chip.
The nanochannel delivery system (nDS) is a battery powered device which can be implanted under the skin (subcutaneous). The device uses a nanofluidic membrane made with a similar technology which is used in the silicon semiconductor industry. The nDS contains a Bluetooth enabled microchip which can be used to remotely control the drug delivery by the device. The researchers have programmed three different drug delivery settings into the microchip namely standard, decreased and increased which can be wireless controlled by Bluetooth. For each of the settings a specific voltage gets applied to the silicon nanochannel within the device which alters the concentration driven diffusion of the drug across the nanofluidic membrane thereby regulating the rate of drug released from the implant. The researchers have claimed that the schedule and dosage of drugs can be customized according to the needs of the patient. According to the Houston Methodist research team the device is capable of administering drugs for months even up to one year before a refill is required.
The team has tested the device both in in vitro and in vivo models for the treatment of chronic ailments such as rheumatoid arthritis and hypertension. Both these chronic diseases require long-term drug delivery where the drug has to be administered at varying doses at scheduled times based on the patient’s needs and requirements. The team has successfully demonstrated the regulated release of drugs enalapril (used for treatment of hypertension) and methotrexate (used for treatment of rheumatoid arthritis) by the nDS device for the treatment of the respective diseases in an in vitro model. They have also demonstrated efficient remote communication with the device in an in vivo model. According to the research team the device also showed biocompatibility in the in vivo model.
The nanochannel delivery system (nDS) has two important advantages which gives it an edge over the conventional drug delivery system currently being used as pain or insulin implants:
- Unlike current drug delivery devices which depend on external pumping mechanisms and require refilling after couple of months this ingenious device functions without external pumps or ports and can easily deliver drugs up to a year.
- On the contrary to conventional drug delivery systems which offers a pulsatile release that may affect response and tolerability nDS ensures a continuous drug delivery which overcomes the problem of abrupt fluctuations.
This device could be of great benefit and advantage for patients suffering from chronic diseases. The device can be remotely monitored by clinicians which will ensure that the patients do not miss doses of medicines especially the ones scheduled at odd hours of the night. Patients suffering from the chronic disease can one day be relieved from the painstaking, arduous schedule of taking pills. This remote controlled subcutaneously implantable nanosized device can take over the task by releasing necessary doses of the drug at scheduled times. The researchers are optimistic that this implant may pave way for on-demand delivery platform technology which can be used for long term management of chronic diseases. Using advanced technology this sophisticated implantable device developed by the team can offer personalized drug dosage and timing of administration as required by individual patients. Such customized drug delivery system is necessary for the treatment of chronic diseases which according to CDC (Centre for Disease Control and Prevention) is the most common costly and preventable of all medical problems.
The Houston Methodist research team intends to test the nanochannel delivery system (nDS) in space as well. They have planned to take the remote communication to the next level by testing it on the International Space Station.
Having successfully demonstrated the long-term drug delivery for the treatment of high blood pressure and rheumatoid arthritis in the lab the team is optimistic that this implant as a universal drug implant could revolutionize health care in the future. The researchers feel that if the device is made widely available to clinicians to remotely treat patients then it could improve the patient’s quality of life. This could also reduce the cost to health care system.
Rheumatoid arthritis, hypertension, diabetes are chronic diseases. These lingering ailments require individualized lifelong medication and treatment. Patients suffering from chronic ailments have a strict schedule of medication which sometimes includes taking pills at wee hours of the night. This makes life inconvenient for the patients. Missed dosage compromises the treatment of these persistent ailments. Since individual patients have different dosage requirements and timings a single approach to tackle the problem of missed doses of medications is challenging. This subcutaneously implantable nanochannel delivery system (nDS) developed by the Houston Methodist research team which can be wirelessly controlled to release regulated doses of drugs has taken a step closer to the goal of developing personalized treatments for individual patients.
- Nicola Di Trani, Antonia Silvestri, Giacomo Bruno, Thomas Geninatti, Corrine Ying Xuan Chua, April Gilbert, Giulia Rizzo, Carly S. Filgueira, Danilo Demarchi, Alessandro Grattoni. Remotely controlled nanofluidic implantable platform for tunable drug delivery. Lab on a Chip, 2019; DOI: 10.1039/c9lc00394k