New drug dose to reduce maternal deaths
Dr Michelle McIntosh
Monash Institute of Pharmaceutical Sciences (MIPS) researchers Dr Michelle McIntosh (BPharm 1995, BPharm(Hons) 1996, PhD 2000), Dr Richard Prankerd and Dr David Morton are working with the aid of a Bill and Melinda Gates Foundation grant to develop more accessible treatments for postpartum haemorrhaging, a complication that occurs following childbirth.
Every year 150,000 women, mostly in developing countries, die due to postpartum haemorrhaging. This figure represents one quarter of all maternal deaths worldwide, yet the condition is largely preventable with the administration of correct medication. The problem stopping more widespread use of the correct drugs is that they are not well suited to transportation, storage and administration in resource-poor countries.
“The drug of choice for treatment of postpartum haemorrhage is oxytocin, which is given via injection,” said Dr McIntosh. “This presents complications in developing countries where it is often not possible to provide sterile equipment, clean water or trained medical personnel during childbirth. Also, the current injectable formulation needs electricity for refrigerated conditions to prevent drug degradation.”
The $100,000 Grand Challenges Exploration Grant will be used by the team at MIPS to develop a novel aerosol delivery system for oxytocin that can be inhaled by patients immediately after childbirth from a simple disposable device. This will remove the need for sterile conditions and cold-chain storage.
“The additional benefit of an aerosol delivery system is the elimination of the risk of needle-stick injuries, transmission of blood-borne viruses and the costs associated with the disposal of sharps and biohazard waste materials,” explained Dr McIntosh.
Scientific literature from the 1960s indicates oxytocin can be successfully delivered via the lining of the nose and mouth, but this delivery method was not initially examined for clinical application. Injectable oxytocin proved effective in managing postpartum haemorrhage in developed nations, removing the driving force for these technologies to be developed further.
“Oxytocin is an ideal candidate for delivery via the lungs. It is a highly potent drug, so only a small amount would be required to enter the systemic circulation. And its demonstrated absorptiveness in the nose and mouth suggests a passage through the huge absorptive surface of the lung is unlikely to present obstacles,” added Dr McIntosh.
“Also, there has been significant progress in aerosol powder development in recent years, as well as in medical device manufacture. This makes it feasible to produce simple, efficient delivery systems that could be used for drug administration by people living in remote areas.”
The well-established safety and efficacy of oxytocin will fast-track development of the proposed treatment and, as a result, improved medication may be available within a short period of time.