Many people with diseases such as Crohn’s disease, rheumatoid arthritis, and diabetes have to inject themselves or their caregivers with the drugs they need to treat their disease. These injections require some training, adequate tools and can make patients’ quality of life more difficult, also negatively affecting adherence to therapies. But what if it were possible to take monoclonal antibodies, insulin and other injectable drugs in pill form? A study conducted by researchers at Brigham and Women’s Hospital, Massachusetts Institute of Technology (MIT) and Novo Nordisk are experimenting with a self-injecting capsule, called L-SOMA, which delivers typically injected liquid drugs orally. The results are published in Nature Biotechnology. At Frontiere.it the professor Carlo Giovanni Traverso of the Division of Gastroenterology, Hepatology and Endoscopy of Brigham Hospital and of the Department of Mechanical Engineering at MIT, tells how the idea of a robo-pill was born, how it works and what advantages it can have for health and also the health system.
For which type of drugs is the L-Soma technology you have developed suitable?
Any injectable drug can be loaded into the L-SOMA device which is the size of a blueberry and can currently contain approximately 4 mg of the drug. In preclinical models, we used this technology to deliver four commonly injected drugs: including a monoclonal antibody. At the moment the trial has been carried out on pigs, but we hope to be able to start the one on patients as soon as possible.
A mini-camera pill to discover bowel diseases
by Annalisa Bonfranceschi
How did the idea for a self-injecting capsule come about?
This new work builds on our previous study published in Science in which we described a self-orienting system that injects solid drugs but doesn’t work with liquid ones. This innovation extends the technology developed by allowing the device to work with liquid drugs that need to be absorbed more quickly or that are difficult to formulate as solids.
100 billion from Europe to plan the future. In conversation with Mariya Gabriel
by Giuliano Aluffi
How does the device work?
We have developed a capsule capable of delivering soluble drugs such as insulin, adalimumab (a monoclonal antibody used to treat rheumatoid arthritis, Crohn’s disease and other autoimmune diseases), epinephrine (adrenaline) and a GLP-1 analog (used to diabetes and obesity). The pill contains a retractable needle that injects the treatment directly into the tissue inside the stomach. The ingestible capsule can orient itself and automatically inject a solution of the drug into the stomach wall and then retract the needle.
Blood cancer, Artificial Intelligence and machine learning for tailor-made treatments
by Irma D’Aria
How does the capsule position itself with the needle in the right way?
We were inspired by the steep-domed shell shape of the leopard tortoise that allows the animal to right itself if it rolls on its back. The device, in fact, uses the weighted lower part and the pointed upper part to rotate autonomously until it positions itself with its injection mechanism flush against the fabric wall. This ensures that the drug enters the tissue and is not broken down by enzymes in the stomach. After administration, the capsule retracts the needle into its shell so that it can safely pass through the gastrointestinal tract. The administration of a liquid formulation allows the absorption and effects of the drug within five minutes of ingesting the capsule.
Exoskeletons, sensors, polymers: six startups for six innovative projects
How did you test the effectiveness of the robo-pill?
We tested the L-Soma devices in pigs by inserting the dosage of one of the four treatments into the capsules. Then, by collecting blood samples from each of the animals, we found that the L-Soma pill delivered drugs at levels comparable to those given with an injection. We also observed that repeated treatments with insulin-loaded L-Soma ensured the same blood glucose control results, suggesting it may be effective to administer multiple and subsequent doses using this device.
A research and innovation center for aging well
by Letizia Gabaglio
What are the most important advantages of this new technology?
Today we know that pills are the preferred route of drug delivery, not only for patients, but also for healthcare professionals. If we can make it easier for patients to take medication, we can help improve medication adherence or compliance. Furthermore, we have shown that this mode of administration can be used repeatedly to dose insulin over the course of several days thus demonstrating that it has good potential for use in chronic therapies. A final advantage is related to the dosages: the device is able to deliver up to 4 mg of drug doses per capsule, allowing us to provide clinically relevant doses of a wide range of currently injected therapies. This technological innovation could apply to chronic conditions that require regular dosing of drugs, but also to medical situations that require more sporadic interventions. Mass administration of an otherwise injectable drug also becomes much easier if it can be administered orally.
Given the complexity of the mechanism and the many benefits that this device is able to bring, it is to be expected that the costs will be quite high. Is that so?
This is a very important question and when we start considering commercialization we will have a better idea of the final costs. It is essential to realize that the costs of failing to administer therapy are very high and therefore having systems that make it easier for patients to receive drugs can have a significant impact on both the success of therapy for the patient and the associated cost savings. to any complications due to poor adherence to therapies.
Can the L-Soma injectable pill also be useful for administering vaccines, including anti Covid-19?
Our capsule has the ability to deliver a wide range of active ingredients including proteins and nucleic acids and therefore could potentially deliver the Covid vaccine as well. However, drug / vaccine delivery through this route will need to be investigated further to evaluate both safety and efficacy.
.