Gastrointestinal Motility Monitoring

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Motilis Sàrl Avenue de Cour 48 CH 17 Lausanne Switzerland www.motilis.com contact@motilis.com +41 79 278 1725 October 28 Gastrointestinal Motility Monitoring A Small Magnetic Pill for Monitoring the Mixing and Propelling Functions of the Gut. A Novel and Non-Invasive Technology for Drug and Food R&D. MTS-1 Motilis Tracking System Detector adapted for large animals (dog, pig) Pill designed for dog (left) and rat (right) Detector for rodents - rat, mouse, rabbit - with real time display of the motility -1-

Our Innovative Approach Motilis offers a unique non invasive technology to measure the mechanical activity of the digestive tract. An ingestible pill, containing a permanent magnet, combined with an external array of magnetic field sensors allows the recording of the local activity and of the dynamics of the transit, for each segment of the GI tract and with a very good spatio-temporal resolution. Magnetic Pill + Array of Sensors Algorithm 3D Position + Orientation Magnetic Pill Detector Processing Motility + Transit Value quantifies GI function localizes a GI dysfunction monitors the effect of treatments helps drug development Key Advantages Measurement of motility & transit simultaneously Translation preclinical -> clinical Non-invasive Cost-effective MTS is the unique technique which allows the simultaneous measurement of GI motility and transit. The technique can be translated from preclinical to clinical application: the proposed functional examination is available for small (rodents) and large animals as well as for human. The market of gastrointestinal diagnostic turns towards capsule-based explorations as patientfriendly alternatives to invasive examinations that have dominated the market for decades. Motilis product is superior to existing functional exploration devices because: it is non-invasive, allowing for long-term and repeated studies it can be used for measurement of the entire GI tract it provides new and physiologically relevant information it is cost-effective Our product differs from the other capsule-based product: PillCam (GivenImaging) is complementary to classical endoscopy, but brings no improvement for functional dysfunctions; Bravo (Medtronic), for ph measurement, is limited to diseases of the oesophagus. Motilis product aims to become the gold standard in functional GI exploration. -2-

Applications Today: Drug & food R&D, first clinical studies Future: Diagnostic tool for gastroenterologists Today: R&D First of all, Motilis addresses the R&D market for drug & food development. More knowledge of gastrointestinal dysfunctions is required for designing better drug treatments and customizing them. Industry and academic laboratories are also waiting for a novel tool to better study motility under different conditions or to better understand the physiology of this relatively unknown and complex function of the abdominal brain. Motilis product is the ideal tool to understand and evaluate, in animal and in human, the effect of: Existing and new GI drugs Side effects of drugs Food intake and composition Electrotherapy (SNS, obesity) Surgical interventions Biofeedback Stress Maturation of the gut Knockout genes and others Motilis Customers Nestlé (CH) Novartis (CH) GSK (UK) University Hospital Lausanne (CH) Aarhus (DK) McMaster (CAN) and others Scientific publications (more references on our website): - E. Stathopoulos et al., Magnetic pill tracking: a novel non-invasive tool for investigation of human digestive motility, Neurogastroenterology and Motility, Vol. 17, pp. 148-54, February 25. - R. Guignet et al., Magnet Tracking: a new tool for in vivo studies of the rat gastrointestinal motility, Neurogastroenterology and Motility, Vol. 18, pp. 472-8, June 26. Next development: Clinical Tool Improved diagnostic localization of the medical problem? Targeted therapy monitor efficacy Guided surgery A tool to support the diagnostic of GI functional troubles, more specifically for Dyspepsia, Gastroparesis Constipation Irritable bowel syndrome (IBS). It will answer the main questions: Where is the problem located? Is it permanent or intermittent? Does it respond to the therapy? A tool to help doctors in the prescription of the adequate therapy and in the monitoring of its efficacy. This would be a major improvement over the trial-and-error treatment strategies mostly used today. -3-

Output Translation and rotation of the pill reflect the GI Motor Pattern. 3D and time display of raw data is sufficient for the localization (transit time) and a first evaluation of the local activity. Data postprocessing provides: 3 2 1 Transit Transit time segment by segment Detailed dynamics of the progression Localization Analysis of rhythms Index of motility Local Activity -1 2 Duodenum [1 dot/s] -2-1 1 2 2 1 4 Stomach, 2.8 cpm -4 1 4 Small Intestine, 9.5 cpm -4 1 2 Effect of drugs visible in real time Opioid (oral, dog, stomach) 4 2 1 2 4 2 Ketamine (i.v., pig, colon) 6 minutes of quiescence 3 3 31 32 33 2 4 6 8 1 12 14 16 18 2 Z [mm] 14 1 Prokinetic (i.v., dog, stomach) 6 1 2 3 8 9 1 11 12 13-4-

Products Description Today: MTS-1 fixed detector, pill of any dimensions Future (available in 29): MTS-2 ambulatory device, several pills simultaneously MTS-1 is a versatile device. The system has been scaled down, so that it is available for rodents as well as for large animals. Moreover, size and density of the capsule, as well as position of the detector are easily adaptable to various studies. Magnetic environment. MTS-1 operates in a normal environment, no shielded room is required. The detector must be immobile during the recordings (calibration for the Earth s magnetic field). Large moving ferromagnetic objects (e.g. elevator) close to the detector may produce artefacts. External sensors make possible the detection of artefacts due to movements and breathing of the subject. Pricing (year 28) Product Includes 38 5 CHF (~23 7 EUR) 1 Detector 1 Power supply Discount (parallel recordings): 1 Acquisition & Viewer software Basic 1 % for 2-3 devices 1 Bluetooth USB dongle (when required) 25 % for 4-7 devices 1 Day for on site installation (travel cost not included) 3 % for 8 devices or more 1 Year maintenance and support gold (value 4 CHF including updates, recalibration, Taxes and shipping cost not included. full user support; travel and shipping cost not included). Delivery time: usually 1 month. Hardware parts Included software System Requirement: PC Compatible computer with >1 Ghz CPU and 512 MB RAM, 32 MB or more Graphic card recommended. Supported Operating Systems: Windows 2 sp4, Windows XP sp2. Related Products For rodents For large animals Restriction Box (size XS,S,M,L) 259.- CHF Movement sensor (non ferromagnetic) 189.- CHF Vibration sensor 189.- CHF Respiration Belt (non ferromagnetic) 299.- CHF Magnetic Pill 1 mm (gold coated) 5.- CHF Magnetic Pills size #3 5.- CHF Not Included: Stand for hammock adaptation, request for a quote. MTS-1 rental (rodents or large animal) 1.- CHF/Day (5% refund possible on purchase) Staff for data acquisition, technical teaching, training 1.- CHF/day Laptop computer quote on request Taxes and shipping cost not included. -5-