Health Monitoring Pharmaceuticals Precision Medicine

What are Smart Pills?

Jagjeet Hara — McMaster Biomedical Discovery & Commercialization 2023

According to Statistics Canada, gastrointestinal (GI) diseases are responsible for over 300,000 deaths each year in Canada across all ages (3). GI diseases are predicted to increase over the next ten years and can impact human health on a global level. Common causes of digestive issues within our population involve chronic stress, harmful pesticides, and the consumption of the Standard American Diet (3)(4).

After identifying this increase in disease prevalence, researchers are aware that there is a gap in diagnostic technology assessing GI symptoms. By turning to the world of smart medical devices, we open up a variety of options for GI disease diagnosis. One of these examples is the SmartPill device.

The SmartPill is a wireless capsule that a physician can use which monitors parameters such as pH, pressure, gastrointestinal transit time, and temperature throughout your digestive tract (5). The capsule is currently approved by the FDA for the diagnosis of conditions that are related to gastric emptying delays and general gastrointestinal motility disease (6).

SOURCE: BASS Medical Group (1)

The SmartPill functions as an endoscopic capsule. Patients swallow an activated wireless pH, pressure, and temperature capsule. This capsule contains sensors that measure pH (with a range of 0.5-9), temperature (with a range of 25-49 °C), and pressure (with a range of 0-350 mmHg) (5). After ingestion, the capsule signals are transmitted from within the GI tract and captured by a receiver. The data receiver is a portable device worn on a belt or a lanyard by the patient and it records information collected by the capsule (5). The data is then stored in the device and transmitted to a computer which provides the physician with the necessary information to evaluate the function of the patient’s stomach and intestines. The patient then continues with their day-to-day activities, and the pill is usually passed within 1-2 days. After passing the pill, the patient returns the data recorder to the physician’s office where the results are then analyzed.

SOURCE: Wang et. al (2)

The current standard of care for diagnostic procedures involves invasive or uncomfortable methods such as upper GI barium swallow tests, gastroscopy, endoscopy, or gastric manometry. The use of the SmartPill, however, may mitigate patient discomfort due to its ingestible approach. For the reliability of results, a study was done assessing the clinical use of wireless motility capsules. The SmartPill capsule detected a generalized motility disorder in 51% of patients (7). The capsule was also shown to influence management decisions in 30% of patients with lower GI disorders and 88% of patients with upper GI disorders (8).  These results show that the SmartPill can function as an advantage to our healthcare system by comfortably assessing gastrointestinal parameters, allowing seamless data collection, and providing physicians with assistance for disease management.


  1. Diagnostic Test: SmartPillTM Motility [Internet]. [cited 2023 Jan 26]. Available from:
  2. Fig. 5 CAD drawing of SmartPill ® with the location of the sensors and… [Internet]. ResearchGate. [cited 2023 Jan 26]. Available from:
  3. Government of Canada SC. Deaths, by cause, Chapter XI: Diseases of the digestive system (K00 to K93) [ Internet]. 2022 [cited 2022 Nov 27]. Available from:
  4. Browning KN, Travagli RA. Central Nervous System Control of Gastrointestinal Motility and Secretion and Modulation of Gastrointestinal Functions. Compr Physiol. 2014 Oct;4(4):1339–68.
  5. Tu P, Chi L, Bodnar W, Zhang Z, Gao B, Bian X, et al. Gut Microbiome Toxicity: Connecting the Environment and Gut Microbiome-Associated Diseases. Toxics. 2020 Mar 12;8(1):19.
  6. Cassilly D, Kantor S, Knight LC, Maurer AH, Fisher RS, Semler J, et al. Gastric emptying of a non-digestible solid: assessment with simultaneous SmartPill pH and pressure capsule, antroduodenal manometry, gastric emptying scintigraphy. Neurogastroenterol Motil. 2008;20(4):311–9.
  7. SmartPill Wins 510(k) Release From FDA [Internet]. BioSpace. [cited 2022 Nov 27]. Available from:
  8. Saad RJ, Hasler WL. A Technical Review and Clinical Assessment of the Wireless Motility Capsule. Gastroenterol Hepatol. 2011 Dec;7(12):795–804.
COVID-19 Pharmaceuticals

The Implications of Pfizer’s New Antiviral COVID-19 Pill, Paxlovid

Donna Mahboubi—McMaster Health Sciences 2026

Chances are you’ve heard mentions of a COVID-19 pill, but you may be wondering, “What actually is it?” There are many emerging treatments for COVID-19 meant for people who are already infected with the virus, including treatments taken orally. These treatments differ from vaccinations because they actively treat the virus whereas vaccines are used as a preventative measure to avoid getting infected in the first place. Similarly to the COVID-19 vaccines, however, Pfizer is one of the first to hop onto the COVID-19 pill train, having created the first FDA-approved oral treatment for COVID-19, Paxlovid (1).

What exactly is Paxlovid?

Paxlovid is the combination of two nirmatrelvir pills and one ritonavir pill, all taken twice a day over the span of five days (2). Nirmatrelvir, a drug created by Pfizer, is the drug in Paxlovid that contains Paxlovid’s antiviral properties, limiting the replication of the virus (2). Ritonavir, an existing drug typically used in the treatment of HIV/AIDS among other things, allows nirmatrelvir to remain in the body at higher concentrations for longer periods of time; it does this by being a CYP, cytochrome P450, inhibitor (3). CYPs are enzymes that are involved in the termination of many drugs, including nirmatrelvir, so inhibiting them enhances and prolongs the antiviral properties of nirmatrelvir. It is recommended that Paxlovid is taken within five days of symptom onset (1).



Nirmatrelvir and ritonavir clearly work together to create a powerhouse of a COVID-19 treatment that demonstrates immense benefits. A nearly five-month-long clinical trial conducted by Pfizer, which concluded in December 2021, showed an 89% decrease in severe illness and death when the drug was taken within three days of symptom onset as compared to a placebo (4). This trial, called EPIC-HR was done on adults who present a high risk of COVID-19 progressing to a severe illness. In the same trial, 0.7% of patients who received Paxlovid were hospitalized as opposed to 6.5% who received the placebo being hospitalized or dying (4). In a second trial, EPIC-SR, done on adults at a more standard risk, hospitalization was reduced by 70% as compared to the placebo (4).

However, Paxlovid is not perfect. It’s not recommended for certain populations such as those with severe kidney or liver impairments (1). A lack of research also makes it difficult to prescribe to certain populations such as people under 40 kilograms, pregnant or lactating people, and those on drugs that could have potentially dangerous interactions with Paxlovid (5).

Implications and the Future

Paxlovid has not only paved the way for other COVID-19 antiviral pills, but also for other forms of COVID-19 treatments. These include antiviral-type treatments, such as the oral treatments Paxlovid and Molnupiravir, and the intravenous treatment Remdesivir (6). Monoclonal antibodies are another form of COVID-19 treatment that improve the immune system’s response to the virus as opposed to targeting the actual virus itself. Bebtelovimab is a monoclonal antibody that combats COVID-19 through intravenous injection (6). Paxlovid is just the beginning, and the creation of new COVID-19 treatments can improve the accessibility of a treatment for those who can not take Paxlovid for a multitude of reasons or in situations where Paxlovid is not available.


The accessibility of Paxlovid has actually been a large issue. This is in part due to the lack of transparency that producers of Paxlovid have demonstrated, particularly in the realm of costs and remaining supply. The lack of transparency has led to challenges in lower-income countries receiving the treatments, resulting in the WHO declaring its concerns regarding Paxlovid accessibility (5). The COVID-19 pandemic has already led to great global divides, and Paxlovid’s limited accessibility gives it the potential to further increase disparities within global health.

Although the future of COVID-19 treatments and the potentially negative implications of Paxlovid are greatly unknown, its introduction into the world of healthcare is quite beneficial and exciting. Paxlovid has opened up a new realm of research within the topic of COVID-19 and has provided an amazing opportunity for collaboration to lead to many incredible discoveries!


  1. Louisiana Department of Health. FDA authorizes first antiviral pills for COVID-19 [Internet]. [cited 2022 Nov 28]. Available from:
  1. Yeboah N, Nijjar H, Piper D. How does Pfizer’s COVID-19 pill work, and who will get it? | CBC News [Internet]. CBC. 2022 [cited 2022 Nov 28]. Available from:
  1. NIH. Paxlovid Drug-Drug Interactions | COVID-19 Treatment Guidelines [Internet]. [cited 2022 Nov 28]. Available from:–paxlovid-/paxlovid-drug-drug-interactions/
  1. Pfizer. Pfizer Announces Additional Phase 2/3 Study Results Confirming Robust Efficacy of Novel COVID-19 Oral Antiviral Treatment Candidate in Reducing Risk of Hospitalization or Death [Internet]. [cited 2022 Nov 28]. Available from:
  1. Jerving S. WHO recommends Pfizer’s COVID-19 pill, but poor nations may lack access [Internet]. Devex. 2022 [cited 2022 Nov 28]. Available from:
  1. CDC. COVID-19 and Your Health [Internet]. Centers for Disease Control and Prevention. 2020 [cited 2022 Nov 28]. Available from:
  1. CBC News. How do I get the COVID-19 medication Paxlovid? | CBC News [Internet]. CBC. 2022 [cited 2023 Jan 11]. Available from:
  1. CDC. COVID-19 and Your Health [Internet]. Centers for Disease Control and Prevention. 2020 [cited 2023 Jan 11]. Available from:
mRNA Pharmaceuticals Precision Medicine

Targeting Pancreatic Cancer: The Race for a Vaccine

Madhura Kadam—McMaster Biology & BND 2023

We are very close to a pancreatic cancer vaccine. Indeed, there are currently many clinical trials being conducted that are testing the efficacy of various pancreatic cancer vaccines candidates—some with promising preliminary results.

To provide some background, pancreatic cancer is the fourth most common cause of cancer death in the U.S.3. Pancreatic cancers occur when cells in the pancreas are damaged, causing them to grow out of control3. Current treatments available to treat pancreatic cancer include surgery, chemotherapy, radiation therapy, immunotherapy and dietary changes2. Vaccines that treat cancers, also known as therapeutic vaccines, are a type of cancer treatment called immunotherapy1. These vaccines work to boost the immunity of the patient to fight cancers1.

Figure 1. Image depicting pancreatic cancer. Adapted from the National Cancer Institute9

There are currently many promising clinical trials underway testing vaccines for pancreatic cancer. One of the most successful trials was conducted by Dr. Balachandran in collaboration with the BioNTech company5. They created a mRNA vaccine that targeted neoantigen proteins5. Neoantigens are proteins present on the cancer that alert the immune system of the presence of abnormal development in the body to stop the cancer from spreading5. In 8 of the 16 patients, the vaccine activated T cells of the immune system that recognize the patient’s own pancreatic cancer cells, triggering the immune system to attack the cancer6. There were also delays in the recurrence of pancreatic cancers in these patients5. These findings suggest that T-cell activation of the immune system through the vaccine may have the desired effect of keeping pancreatic cancer in check.

Figure 2. Targeting neoantigen proteins. Adapted from Pearlman et al8

Figure 3. Mechanism for the functioning of cancer vaccines. Adapted from Roy7

mRNA vaccines are created by genetically sequencing the neoantigens proteins in the pancreatic tumors of patients5. The genetic sequences of neoantigens act as a template for making mRNA vaccines. When the vaccine is injected into the person’s bloodstream, it causes the immune cells known as dendritic cells to make the neoantigen proteins5. The dendritic cells train the rest of the immune system to recognize and attack tumor cells expressing the same neoantigen proteins5. Since the immune system is aware of neoantigens as a “harmful protein” to the body, the cancer may have less chance of returning as it is most likely to be destroyed by the immune system5.

Another vaccine developed by Elizabeth Jaffee, M.D., and Daniel Laheru, M.D., is also currently in the clinical trial phase1. This vaccine uses pancreatic cancer cells that are treated with radiation to inhibit their ability to grow1. These cancer cells are also altered genetically to secrete a molecule called GM-CSF1. This molecule attracts immune system cells to the site of the tumor vaccine where they encounter antigen proteins of the radiated cells1. Once these antigens are recognized, this trains the immune system to attack any remaining pancreatic cancer cells in the body1. The mechanism for this vaccine is like that of the mRNA vaccine mentioned above, but the specific proteins and antigen targets that are used differ between the two treatments.

Many other clinical trials for pancreatic cancer vaccines are also currently under development4. These trials include vaccines that are cell based, DNA-based, peptide based and microorganism based4. In summary, many pancreatic cancer vaccines are currently under development at different stages of testing. More clinical testing and FDA approval is required for these vaccines to be commercially available, however the advancements in current vaccinations point to a hopeful future for vaccines to be an effective treatment for pancreatic cancers.


  1. Hopkins Medicine. Pancreatic cancer vaccine [Internet]. Pancreatic Cancer Vaccine | Johns Hopkins Medicine. 2022 [cited 2022Nov27]. Available from:
  2. Hopkins Medicine. Pancreatic cancer treatment [Internet]. Pancreatic Cancer Treatment | Johns Hopkins Medicine. 2022 [cited 2022Nov28]. Available from:
  3. Hopkins Medicine. Pancreatic cancer [Internet]. Pancreatic Cancer | Johns Hopkins Medicine. 2022 [cited 2022Nov28]. Available from:
  4. Huang X, Zhang G, Tang T-Y, Gao X, Liang T-B. Personalized pancreatic cancer therapy: From the perspective of mrna vaccine – military medical research [Internet]. BioMed Central. BioMed Central; 2022 [cited 2022Nov28]. Available from:
  5. MSKCC. MSK mrna pancreatic cancer vaccine trial shows promising results [Internet]. Memorial Sloan Kettering Cancer Center. 2022 [cited 2022Nov28]. Available from:
  6. Page ML. Pancreatic cancer vaccine: What to know about early promising results [Internet]. New Scientist. New Scientist; 2022 [cited 2022Nov28]. Available from:
  7. Roy S. Cancer vaccines: Are we there yet? [Internet]. Cancer Vaccines: Are We There Yet? | Vanderbilt Institute for Infection, Immunology and Inflammation. 2020 [cited 2023Jan4]. Available from:
  8. Pearlman AH, Hwang MS, Konig MF, Hsiue EH-C, Douglass J, DiNapoli SR, et al. Targeting public neoantigens for cancer immunotherapy [Internet]. Nature News. Nature Publishing Group; 2021 [cited 2023Jan4]. Available from:
  9. National Cancer Institute. Pancreatic cancer treatment (adult) (PDQ®)–patient version [Internet]. National Cancer Institute. 2020 [cited 2023Jan4]. Available from:
COVID-19 Pharmaceuticals

The Future of Vaccine Companies: Unceasing Competition

Seonhwa Lee—McMaster Honours Human Behaviour 2024

With decreasing trend in infection cases and lighter restrictions following the expedite development of effective vaccine supply, it seemed like the world was finally coming back to normal. This hope is now shattered with the recent emergence of omicron, the new variant of COVID virus. At this time of inflection, what is the future of major vaccine companies?

Engaging Variant and Booster Vaccines

Omicron varies from other COVID viruses in its numerous mutations in the spike protein, which the vaccine aims to mimic to produce antibodies. In fact, studies were conducted by Pfizer and BioNTech to see a significant decrease in the number of virus-targeting antibodies in omicron (1). They also found evidence to support the efficacy and efficiency of booster shots in increasing the production of antibodies as well (1). Booster shot is injected after an individual has received one or two previous doses of regular vaccine against COVID depending on the type.

SOURCE: The Sudbury Star

The Canadian government had authorized companies producing viral vector-based vaccines such as Janssen and AstraZeneca for adults over 18 years of age, and mRNA vaccines such as Moderna and Pfizer and BioNTech (2-5). mRNA vaccines were given full approval to give children over 5 (Pfizer-BioNTech) and 12 (Moderna) with reduced dose, and Spikevax by Moderna was especially approved as a booster shot in November (4-6). Pfizer and BioNTech is also planning to drop their new vaccine adjusted to target omicron in March 2022 depending on the need, as well as 4 billion more of their current Comirnaty vaccine supply (1).

Antiviral Pills

 Aside from vaccines, companies are also striving to develop pills to cure. Pfizer is in the lead among major companies with their two-pill antiviral named Paxlovid, which showed outstanding efficacy by dropping hospitalization and death by 89% (1). Paxlovid is used to treat relatively mild symptoms in unvaccinated individuals and the above-mentioned result was when patients took the pill within three days of symptoms (1).

Merck also dropped a one-pill antiviral called Molnupiravir less impact than Paxlovid by reducing hospitalization and death by 30% when taken within five days after symptoms first appeared but is still clearly in lead compared to other companies (1).

Progress on making the most effective vaccine or cure is a key factor in the inevitable competition among these pharmaceutical companies.

Side Effects and Post-Pandemic

Despite the fact that all types of vaccine currently used by countries are authorized and approved for its “safety”, current vaccines are suspected of possible side effects spanning from light redness and swelling to serious hear inflammation (7).

SOURCE: Today Show

Once confirmed cases decrease again and the pandemic gets closer to the end, the corporates will likely have a decreased stock value and maybe change the price to directly target the public with COVID products remaining on the market and focusing more on regular products they had before the virus; if they are still authorized despite the side effects with no immediate threat.


  1. Gatlin A. Is Pfizer stock a buy as omicron partially eludes its Covid vaccine? [Internet]. Investor’s Business Daily. 2021 [cited 2021Dec11]. Available from:
  2. Canada H. Government of Canada [Internet]. / Gouvernement du Canada; 2021 [cited 2021Dec11]. Available from:
  3. Canada H. Government of Canada [Internet]. / Gouvernement du Canada; 2021 [cited 2021Dec11]. Available from:
  4. Canada H. Government of Canada [Internet]. / Gouvernement du Canada; 2021 [cited 2021Dec11]. Available from:
  5. Canada H. Government of Canada [Internet]. Pfizer-BioNTech Comirnaty COVID-19 vaccine – / Gouvernement du Canada; 2021 [cited 2021Dec11]. Available from:
  6. Canada H. Health Canada authorizes the use of the Moderna Spikevax COVID-19 vaccine as a booster shot [Internet]. Government of Canada; 2021 [cited 2021Dec11]. Available from:
  7. Gatlin A. Is moderna stock a buy or sell as shares Yo-Yo on the omicron threat? [Internet]. Investor’s Business Daily. 2021 [cited 2021Dec11]. Available from:

How Does Computational Drug Discovery Work?

A Brief Introduction To Computational Drug Discovery And Its Applications

Namya Mehan — McMaster University Integrated Biomedical Engineering & Health Sciences 2024

Over the past year, we all have been hearing a lot about molecules such as chloroquine, remdesivir, lopinavir/ritonavir, etc. But have you ever wondered what these are, what they aim to do, and where they come from? All of them are small-molecule drugs that were under trial by the World Health Organisation to test their effectiveness against COVID-19. All drugs, small or large molecules, are obtained through a process called drug discovery, by which a drug candidate is identified and partially validated for the treatment of a specific disease.

This process of drug design and discovery involves many steps, such as studying the mechanism of action of various drugs, target selection and validation, lead identification and optimization, drug toxicity, and other mechanical and chemical properties,  including pharmacokinetics and pharmacodynamics1.

Figure 1: Traditional Drug Discovery Process. Source: Drug Discovery, All About Drugs

Given the number of steps in the process of drug discovery, it is evident that it can be extremely time-consuming, risky, and costly. A typical discovery and development process takes about 14 years to introduce a drug to the market, costing about 0.8 to 1 billion USD!1 These statistics exemplify the significant drainage of time and money associated with the cycle of drug discovery and development. But the question is, is there a way to make it any faster and cheaper? Yes.

Like everything else, from calculations to writing, drug discovery can also be made faster by computational methods. Developments in combinatorial chemistry and screening technologies have enabled the screening and synthesis of huge libraries of compounds in a short period of time. Computational drug discovery consists of computer programs and tools for designing compounds, lead identification, and repositories to study drug-target interactions. By using these approaches for various stages of the discovery process, the cost of drug development can be halved! The computational drug discovery approaches that are commonly used can be classified into three categories, structure-based drug design (SBDD), ligand-based drug design (LBDD), and sequence-based drug design.

Figure 2: Computational Drug Discovery Approaches. Source: Nature Articles, Computational Drug Discovery1

SBDD methods include molecular docking and De novo drug design which both rely on knowledge of the target macromolecule from 3D structures of potential targets. In absence of these 3D structures, LBDD tools provide information about the drug targets and ligand interaction. These tools allow for the construction of predictive models suitable for drug discovery and optimization. Some examples include quantitative structure-activity relationship, pharmacore modeling, molecular field analysis, and 3D similarity assessment. In situations where neither the target nor the ligand information is available, sequence-based approaches that use bioinformatic methods have been developed to identify potential targets and conduct lead discovery. Considering the practical needs of drug discovery, usually, all three approaches mentioned are used in combination to deliver successful results.

There exist several methodologies to support various steps in the drug discovery process. These include using web servers such as TasFisDock that identify drug targets using reverse docking to seek all binding proteins for a given molecule, docking-based virtual screening (SBDD) using GAsDock, a docking methodology with an optimization algorithm that results in more reasonable and robust binding modes between ligands and macromolecules, computational methods such as Cyndi assist in conformational sampling as the algorithms optimize energy and diversity features, virtual libraries play an important role in de novo drug design as they help to overcome challenges in selecting fragment sets for new drug leads. These are some examples of how computational methods are revolutionizing drug discovery.2

While these methods have great potential, the drug discovery process is not completely reliant on computational techniques in a black-box manner. Computational components of research are, and should always be, supplemented and coupled with experimental resources. Future challenges would include the coupling of chemistry and biology with chemoinformatics and bioinformatics, to result in pharmacoinformatics.3 This integration would lead to an increase in the accuracy and effectiveness of computational methods, making them more reliable and trustworthy.

References and Further Reading

  1. Ou-Yang S-sheng, Lu J-yan, Kong X-Qian, Liang Z-Jie, Luo C, Jiang H. Computational drug discovery. Acta Pharmacologica Sinica. 2012;33(9):1131–40.
  2. Sliwoski G, Kothiwale S, Meiler J, Lowe EW. Computational Methods in Drug Discovery. Pharmacological Reviews. 2013;66(1):334–95.
  3. Schaduangrat N, Lampa S, Simeon S, Gleeson MP, Spjuth O, Nantasenamat C. Towards reproducible computational drug discovery. Journal of Cheminformatics. 2020;12(1).