US researchers have developed a capsule that can slowly release a combination of antiretroviral drugs over a week. A progress for compliance and efficiency.
The treatment of HIV infection requires taking a combination of drugs once or twice a day for life, making adherence to treatment difficult and most importantly, impairing effectiveness. But up to 30% of people living with HIV do not follow their treatment.
Researchers at Massachusetts Institute of Technology (MIT) and Brigham and Women's Hospital in Boston, USA, reportedly developed a pill that should only be taken once a week. They reported the details of their new weekly capsule in the review Nature Communications.
A polymer that stays in the stomach
The researchers decided to rely on an ingestible capsule polymer that can remain in the stomach for two weeks and to administer a combination of drugs.
Some capsule design changes have been necessary to make it effective for HIV treatment. The original capsule consisted of six arms made of a single polymer. Each arm is loaded with medicine and folded. After ingestion, the arms unfold and release the drugs. However, for the treatment of HIV, the capsule had to be able to release different drugs at different rates - something that the original design did not allow. The team has adapted the design. The main structure of the new capsule is still constructed from a single base polymer, but each of the six arms may contain a different drug, through the addition of different "release polymers".
A pillbox in a capsule
In a way, it's like putting a pillbox in a capsule. There are rooms for each day of the week on a single capsule. Once all the drugs are released, the capsule disintegrates, allowing it to go down into the intestine.
To test whether the newly designed capsule could be effective against HIV, researchers have loaded it with three different antiretroviral drugs - dolutegravir, rilpivirine and cabotégravir - that are currently used both to prevent and treat HIV.
By testing the capsule loaded with drugs on the pigs, the researchers found that the capsule had started working successfully in the animals' stomachs, and that they gradually released each of the three drugs over a period of one year. week.
Of course, the capsule needs to be tested in humans before it can be used for HIV prevention and treatment, but researchers believe the results of their study are promising. They suggest that the pill could increase the effectiveness of HIV preventive treatment by 20%.