Monday, September 24, 2018

New digital way of medicating TB patients gives new hope

  • Nurul Islam Hasib from Guadalajara in Mexico,
    Published: 2017-10-13 01:59:47 BdST


A new digital way of monitoring the tuberculosis treatment has been presented at the 48th Union World Conference on Lung Health in Guadalajara, ushering in a new era of TB science.

Directly Observed Therapy (DOT) is universally recommended to ensure long tuberculosis treatment adherence.

Now researchers said the Wirelessly Observed Therapy (WOT) is more effective and has the potential to transform TB treatment adherence.

“WOT has the potential to treat tens of thousands of people more effectively which means more people cured and less people developing multidrug-resistance – a real game changer,” said José Luis Castro, Executive Director of The Union, the organiser of the conference, on Thursday.

Sara Browne, associate professor of medicine of the University of California, San Diego who did the study, at a press briefing, said WOT works on existing cell phone and internet infrastructure, requires few personnel, and covers distance.

She said this is “highly relevant if appropriately adapted to countries that lack medical personnel and infrastructure”.

There is no limit to the number of patients WOT can monitor.

TB patients are put on several drugs for several months. Only adherence to the schedule of taking those drugs and completing the courses can ensure success of treatment outcomes.

WOT is the first technology that allows date and time stamping of actual ingestions of oral medications.

The FDA approved WOT device, consists of an edible ingestion sensor (IS), external wearable patch and paired mobile device, can detect and record ingestion events, which are uploaded to a secure Internet server, where healthcare workers can confirm ingestions remotely.

The sensor was combined with Rifamate via co-encapsulation within certified gelatin capsules.

“We combined fixed dose combination Isoniazid and Rifampin with IS to generate 'digitized' ISRifamate; and evaluated the accuracy of WOT in comparison to DOT in multi-drug resistant TB patients during continuation therapy," Browne said.

She said DOT is resource intensive, intrusive and expensive with limited implementation in resource limited settings contributing to increased rates of resistant multi-drug resistant TB.

The edible sensor is a microchip coated with very thin layers of commonly ingested excipients such as minerals and metals.

The active layers are thin films of magnesium and cuprous chloride with a gold under-layer that acts as current collector.

Browne said each dose of medication can be enabled with an ingestible sensor or co-ingested with a sensor-enabled pill.

“The ingestible sensor communicates wirelessly to a patch worn on the body, which controls data about medication intake, as well as other physiological metrics.

“Data is wirelessly transferred to the patient’s mobile device – a phone or tablet computer. Medication reminders can also be sent to the device.

“Data is securely transferred to a server via the cellular network.

Healthcare professionals can remotely review medication adherence and physiological data of groups of patients,” she said.

WOT digital data has potential to provide digital summaries within minutes to TB control programmes.

No adverse effects occurred in relation to sensor ingestions. FDA approved the system.

She, however, said further clinical trials can be conducted in diverse global settings.

Releasing cutting-edge technologies is one of the focuses on the lung health conference.

“We appear to be on the cusp of serious progress in TB science,” Luis Castro said, “This progress is fundamental if we are to improve the way we find and treat people living with TB”.

The conference will end on Saturday.