Healthcare, WVU News

WVUM Rockefeller Neuroscience’s Ali Rezai explains their ingestible smart pill research and potential for drug overdose detection

MORGANTOWN – WVU Rockefeller Neuroscience Institute executive chair Dr. Ali Rezai met with The Dominion Post to delve more into the lifesaving potential of a new ingestible smart pill that could help detect drug overdoses – among other possible uses.

RNI last week announced the initial research of the Celero Systems Vitals Monitoring Pill that was published in Device, a cutting-edge technology applied research journal. The Dominion Post visited with Rezai at RNI to learn more about it.

The smart pill (right) and its flavored shell

The battery-powered VM Pill, the size of a large vitamin capsule, has two chambers and contains electronics and sensors that send signals via Wi-Fi to a phone or any Wi-Fi device. It takes four types of measurements: respiratory rate, heart rate and rhythms; core body temperature (an Apple watch can measure peripheral temperature but that’s less accurate than core temperature); and movements of the intestines.

They worked with an MIT team for about 2 ½ years, Rezai said, to conduct a first-in-the-world in-human study whose first goal was to record those four measures.

After an initial test on pigs (noted in the Device article), the in-human study took place at the WVU Medicine Sleep Evaluation Center on 10 volunteers being evaluated for sleep apnea. The idea, Rezai said, was to see if the pill was as accurate as the gold standard sleep study with all of its external wire hookups.

The study showed the pill’s readings were extremely accurate for the four measures, and when a subject stopped breathing.

“What’s important for us is we can use this now to be able to maybe detect overdoses,” Rezai said. The vast majority of drug users are alone when their breathing slows, and they stop breathing.

But the pill could be used to send a signal to EMS, the medical care team, the family that the person is in trouble, their respiration and heart rate are down – instead of finding a person too late.

The sleep study was followed by a study of volunteers at WVU Medicine’s Center for Hope and Healing residential treatment facility, to see how the volunteers felt about using the technology.

“The response has been very positive,” Rezai said. They were comfortable with it because it’s a pill they can swallow.

And it comes in a flavored shell – including chocolate.

“This technology can save lives, potentially,” Rezai said. About 110,000 people died of overdoses last year, while 800,000 had non-fatal overdoses. With the pill sending out signals around the clock, it can help reach people before it’s too late.

The pill that underwent testing is just the first step, Rezai said. By end of 2024 or into 2025, once they get approvals, half the two-chamber pill will contain an opioid-antagonist medication nalmephene.

Nalmephene is an analog of Narcan (naloxone), Rezaid said, used around the world but not yet FDA-approved in the U.S. Its advantage is the Narcan breaks down in the stomach and is ineffective if administered that way, while nalmphene doesn’t. It can be absorbed in the stomach – the medical term is bioavailable.

The goal is to have a system that is automatically detecting an overdose and releasing the opioid antagonist to reset the heart, he said. “That’s the technology we want to go, step by step.”

Rezai explained that the pill isn’t a long-term tool for a user who may potentially overdose. The current form exits the body in a couple days. The next generation, with three helicopter-like wings at one end, will attach and stay inside for seven days. Then it will automatically detach and be expelled, or a physician can detach it remotely.

There will be other applications for the VM Pill, Rezai said, such as detecting sleep apnea without the external wiring, and detecting heart arrhythmias. WVU Medicine is starting a study in the cardiology department to look at detecting arrhythmias.

“This is the first generation. It’s going to be better and better.”

There’s another important aspect of this research, Rezai said. “We did it here in West Virginia.”

WVU Medicine and RNI want to be a world leader for new technologies and applications. This VM pill is one part of a multifaceted approach to addictions using digital technologies – to predict, detect, treat with unique innovations, and prevent addiction and overdoses.

Other RNI research includes such things as focused ultrasound to deliver neuromodulation energy deep into the brain to reduce the cravings that help drive addiction.

Another technology is a wearable device and an RNI app that can detect cravings or anxiety or mood changes, to help predict a higher risk for taking a substance.