Susan Swindells, MBBS, is one of three co-editors of a new supplement to the journal Clinical Infectious Diseases, a major ID journal and the official journal of the Infectious Diseases Society of America.
The supplement, now published online, focuses on long-acting and extended release drug development for the treatment of infectious diseases such as HIV, tuberculosis, hepatitis and other diseases. The hard-copy release is scheduled for Dec. 1, World AIDS Day.
Long-acting drug development is a longtime interest for Dr. Swindells, who has led clinical trials on long-acting HIV drugs and currently is part of a project working on developing long-acting drugs for tuberculosis, malaria and hepatitis C. A growing number of patients at the specialty care HIV clinic are now getting anti-HIV treatment by long-acting injections every month or even every other month.
“There’s an interest in general in the field of long-acting drug development,” she said, pointing to diverse specialties such as oncology, psychiatry and gynecology that are exploring or using long-acting and extended-release formulations.
For the supplement, Dr. Swindells and her co-editors reached out to experts across the world to provide “a comprehensive look at the long-acting landscape: what’s out there, what’s coming, what are the barriers, what are the potential advantages? Just looking at the big picture,” she said.
Some of the articles include:
- What clinicians need to know about the development of long-acting formulations
- Long-acting formulations for the prevention and treatment of human immunodeficiency virus (HIV)-1 infection: Strategic leveraging and integration of multidisciplinary knowledge to advance public health
- A holistic review of the preclinical landscape for long-acting, anti-infective drugs using HIV as a paradigm
Dr. Swindells herself collaborated on the introduction to the journal and a piece on tuberculosis.
“It’s definitely a field with a lot of activity,” she said.
The supplement also explores new technology in the long-acting arena.
“Most people think of this as an injection,” she said. “There’s other technology now, such as an implant for contraception, and there’s interest in using a microarray patch – like a fancy version of a nicotine patch – that would release a drug over a long period of time and could be used for children and babies. Or even grownups – no one really likes an injection.”
The emerging field is especially of interest to ID, she said, where medication adherence is vitally important – and where some patients may face stigma or judgment for their conditions.
“Forgetting to take medicine is a common thing,” Dr. Swindells said. “But infectious diseases are not forgiving. If you have HIV medication you’re supposed to take every day and you take it three-quarters of the time, you run the risk of your infection getting resistant. There are more bad consequences for missing.
“And some of these diseases are heavily stigmatized, so patients getting their treatment by long-acting injections like the fact that no one is going to see them taking a daily pill. Also, they don’t have to be reminded every day that they have this disease. It can be freeing.
“With some young people, you could be looking at years of having to take a pill every day, and that’s hard.”
The supplement is supported by the Long-Acting/Extended Release Antiretroviral Research Resource Program.
Dr. Swindells, who currently is focused full-time on research, called the supplement a nice project toward the end of her career.
“At UNMC, we’ve done a lot of the big clinical trials that have led to the approval of the long-acting medicines we’re now using,” she said, pointing to a 2019 New England Journal of Medicine study she first-authored. “So it’s all kind of coming together.”
Congrats Dr. Swindells!
Congratulations Dr. Swindells, one of the brightest minds at UNMC!