What if there was a drug delivery system intuitive enough to respond to changes in a patientâ€™s disease?
What if there was a drug delivery system intuitive enough to respond to changes in a patient’s disease? What if patients didn’t need to remember to take their medications and could instead rely on an implantable device to administer a dose for them?
This is what current research is working towards, according to Adah Almutairi, PhD, professor of pharmaceutical chemistry at UC San Diego and director of UCSD Center of Excellence in Nanomedicine and Engineering.
At the Spotlight on Science session held at the 2018 ASHP Midyear Clinical Meeting and Exhibition on Wednesday, Dr Almutairi provided insight into the development of innovative drug delivery systems and the design of feedback release drug depots.
According to Almutairi, 1 in 4 patients who visit a physician do not fill their prescription. Of the patients who do fill their prescription, approximately 50% take their medications as prescribed.
“It’s hard to keep up,” Dr Almutairi said. “We are only humans and we have a lot going on in our lives.”
Medication nonadherence currently translates to $300 billion in preventable hospital costs and can lead to negative patient outcomes, according to the American Medical Association.
“I want to find ways to have patients see a doctor or pharmacist just once a year to get their drugs administered,” Dr Almutairi said. “They can forget about it while an implanted device continues to release the right doses at the right time.”
Dr Almutairi’s research hints at promising developments for making this a reality. Using polymers, Dr Almutairi describes housing a biologically active agent needed for treatment in a protective polymeric shell. When housed inside the shell, the chemistry of these agents can be controlled, and their activity can be switched on or off. If the shell is responsive to the disease, it will break up and release the agent. Unlike sustained drug release systems that may release the agent over days or months, the chemistry of the smart feedback drug depot allows it to rapidly degrade to disperse the agent based on the body’s needs.
In testing this concept, Almutairi compared the smart feedback drug release with sustained drug release in ocular drug delivery using a treatment for age-related macular degeneration called a VEGF trap. VEGF traps typically require intraocular injection about once per month, depending on condition severity, in a very invasive and expensive process. To implement this treatment as a smart drug release depot, the VEGF trap was packaged into a polymer shell that was responsive to light and inflammation.
According to Dr Almutairi, the nano capsules remained intact in the eye nearly 1 year after injection, demonstrating stability. Additionally, the system was shown to be responsive to inflammation and appeared to work better than sustained drug release.
She also explained that the technology can be used in imaging diseases as well. In different disease models, such as arthritis and cancer in mice, scientists were able to control the system to identify areas of inflammation in the body.
Patient noncompliance remains 1 of the biggest challenges in medicine. However, technology such as this could be revolutionary for patients with difficult-to-treat, chronic conditions who require costly and complex medications. Almutairi ended the presentation with hope that innovation could effectively eliminate nonadherence and reduce preventable costs and hospitalizations.
“One day, maybe we can take the patient out of the equation of patient compliance,” she concluded.
1. Almutairi A. Smart Feedback Drug Release: Because Drugs Won't Work on Patients Who Don't Take Them.
Presented at: 2018 ASHP Midyear Clinical Meeting and Exhibition. December 2-6, 2018. Anaheim, California.