# A robotic pill for oral delivery of biotherapeutics: safety, tolerability, and performance in healthy subjects

**Authors:** Arvinder K. Dhalla, Ziad Al-Shamsie, Simret Beraki, Anvesh Dasari, Leonard C. Fung, Laura Fusaro, Anusha Garapaty, Betsy Gutierrez, Delia Gratta, Mir Hashim, Kyle Horlen, Padma Karamchedu, Radhika Korupolu, Eric Liang, Chang Ong, Zachary Owyang, Vasudha Salgotra, Shilpy Sharma, Baber Syed, Mansoor Syed, April T. Vo, Radia Abdul-Wahab, Asad Wasi, Alyson Yamaguchi, Shane Yen, Mir Imran

PMC · DOI: 10.1007/s13346-021-00938-1 · Drug Delivery and Translational Research · 2021-02-19

## TL;DR

A robotic pill was developed to safely deliver biotherapeutics orally, avoiding injections by injecting the drug into the small intestine.

## Contribution

The robotic pill enables safe, pain-free oral delivery of biotherapeutics with variable success rates based on balloon size.

## Key findings

- The robotic pill successfully delivered octreotide in 25 to 80% of healthy subjects, depending on balloon size.
- Drug delivery success was associated with a mean bioavailability of 65 ± 9%.
- The pill's deployment was unaffected by whether subjects were fasting or fed.

## Abstract

Biotherapeutics are highly efficacious, but the pain and inconvenience of chronic injections lead to poor patient compliance and compromise effective disease management. Despite innumerable attempts, oral delivery of biotherapeutics remains unsuccessful due to their degradation in the gastrointestinal (GI) environment and poor intestinal absorption. We have developed an orally ingestible robotic pill (RP) for drug delivery, which protects the biotherapeutic drug payload from digestion in the GI tract and auto-injects it into the wall of the small intestine as a safe, pain-free injection since the intestines are insensate to sharp stimuli. The payload is delivered upon inflation of a balloon folded within the RP, which deflates immediately after drug delivery. Here we present results from two clinical studies demonstrating the safety, tolerability and performance of the RP in healthy humans. In the first study, three versions of the RP (A, B and C) were evaluated, which were identical in all respects except for the diameter of the balloon. The RP successfully delivered a biotherapeutic (octreotide) in 3 out of 12 subjects in group A, 10 out of 20 subjects in group B and 16 out of 20 subjects in group C, with a mean bioavailability of 65 ± 9% (based on successful drug deliveries in groups A and B). Thus,  reliability of drug delivery with the RP ranged from 25 to 80%, with success rate directly related to balloon size. In a separate study, the deployment of the RP was unaffected by fed or fasting conditions suggesting that the RP may be taken with or without food. These promising clinical data suggest that biotherapeutics currently administered parenterally may be safely and reliably delivered via this versatile, orally ingestible drug delivery platform.

## Linked entities

- **Chemicals:** octreotide (PubChem CID 448601)

## Full-text entities

- **Genes:** INS (insulin) [NCBI Gene 397415], PTH (parathyroid hormone) [NCBI Gene 5741] {aka FIH1, PTH1}, INS (insulin) [NCBI Gene 3630] {aka IDDM, IDDM1, IDDM2, ILPR, IRDN, MODY10}, GH1 (growth hormone 1) [NCBI Gene 2688] {aka GH, GH-N, GHB5, GHN, IGHD1A, IGHD1B}, GLP1R (glucagon like peptide 1 receptor) [NCBI Gene 2740] {aka GLP-1, GLP-1-R, GLP-1R}
- **Diseases:** irritable or inflammatory bowel disease (MESH:D015212), abdominal discomfort (MESH:D000007), acromegaly (MESH:D000172), gastroesophageal reflux disease (MESH:D005764), ulcers (MESH:D014456), chronic diarrhea (MESH:D003967), GI disorders (MESH:D005767), diverticulitis (MESH:D004238), headache (MESH:D006261), abdominal pain (MESH:D015746), chronic diseases (MESH:D002908), Crohn's disease (MESH:D003424), gastric or duodenal ulcer (MESH:D013276), gastroparesis (MESH:D018589), esophagitis (MESH:D004941), pain (MESH:D010146), nausea (MESH:D009325), dyspepsia (MESH:D004415), MH (MESH:C535694), neuroendocrine tumors (MESH:D018358), ulcerative colitis (MESH:D003093), ischemic (MESH:D002545), dysphagia (MESH:D003680), chronic constipation (MESH:D003248), bulimia nervosa (MESH:D052018), RP (MESH:D014202), esophageal spasm (MESH:D015155)
- **Species:** Canis lupus familiaris (dog, subspecies) [taxon 9615], Sus scrofa (pig, species) [taxon 9823], Homo sapiens (human, species) [taxon 9606]

## Full text

_Full body text omitted from this summary view._ Fetch the complete paper as Markdown: https://tomesphere.com/paper/PMC8677648/full.md

## Figures

7 figures with captions in the complete paper: https://tomesphere.com/paper/PMC8677648/full.md

## References

37 references — full list in the complete paper: https://tomesphere.com/paper/PMC8677648/full.md

---
Source: https://tomesphere.com/paper/PMC8677648