New medications and therapies for multiple diseases, as well as technologies, such as telehealth, hold promise to change treatment dynamics and patient outcomes.
The innovation experts at Cleveland Clinic have peered into their crystal ball and pronounced the most profound medical advancements that will impact the care and treatment of patients in the coming year.
During the closing session of the 2020 Cleveland Clinic Medical Innovation Summit, the 18th year the conference has been held, Cleveland Clinic Innovations shared its annual list of top 10 medical innovations. The breakthrough technologies were selected by a committee of Cleveland Clinic subject matter experts, led by Will Morris, MD, executive medical director, Cleveland Clinic Innovations, and Akhil Saklecha, MD, managing director, Cleveland Clinic Ventures.
1. Gene Therapy for Hemoglobinopathies
Experimental gene therapy gives new hope to those suffering from hemoglobinopathies, genetic disorders responsible for sickle cell disease and thalassemia. Through treatment, those with these conditions have the potential ability to make functional hemoglobin molecules, reduce the presence of sickled blood cells or ineffective red blood cells in thalassemia, and prevent associated complications.
2. Novel Drug for Primary-Progressive Multiple Sclerosis
A new, U.S. Food and Drug Administration (FDA)-approved therapeutic monoclonal antibody with a novel target is the first and only multiple sclerosis (MS) treatment for 15% of primary-progressive patients, who experience gradual onset and steady progression of signs and symptoms. In those with MS, the immune system attacks the fatty protective myelin sheath that covers the nerve fibers, causing communication problems between the brain and the rest of the body that can result in permanent damage or deterioration and eventual death.
3. Smartphone-Connected Pacemaker Devices
Remote monitoring of implantable pacemakers and defibrillators traditionally occurs through a bedside console that transmits data to the physician. Yet many patients don't understand how it functions, and adherence to remote monitoring has been suboptimal. New Bluetooth-enabled pacemaker devices used in conjunction with a mobile app, offer a convenient new method to transmit data, while also providing patients greater insight into their health status.
4. New Medication for Cystic Fibrosis
A new combination drug, approved by the FDA in October 2019, provides relief for patients with the most common cystic fibrosis gene mutation (F508 del), estimated to represent 90% of individuals living with the disease. Medications developed prior to last year had only been effective in a subset of people with certain mutations.
5. Universal Hepatitis C Treatment
A new, approved fixed-dose combination medication has vastly improved hepatitis C treatment. More than 90% effective for hepatitis C genotypes one through six, the therapy represents an effective option for a wider scope of patients. With no vaccine for the hepatitis C virus, patients have been limited to medication, but many treatments were accompanied by adverse side effects or only effective for certain genotypes of the disease.
6. Bubble CPAP for Increased Lung Function in Premature Babies
Newborns with infant respiratory distress syndrome now have access to a safer method of ventilation though b-CPAP, a non-invasive ventilation strategy. Unlike mechanical ventilation, which administers a surfactant that can cause lasting lung injury, b-CPAP maintains lung volumes during exhalation through oscillating, rather than constant pressure, minimizes physical trauma, and stimulates lung growth when administered over a prolonged period.
7. Increased Access to Telemedicine through Novel Practice and Policy Changes
While telehealth technologies and initiatives have been around for years, COVID-19 forced them into the spotlight and stimulated widespread adoption. "Since March, state and federal regulators have moved quickly to reduce telehealth adoption barriers, understanding that these tools can speed access to care while protecting healthcare workers and community members," according to Cleveland Clinic. "These measures opened the floodgates for telehealth, allowing for new programs and the expansion of existing networks."
8. Vacuum-Induced Uterine Tamponade Device for Postpartum Hemorrhage
A low-tech solution is now part of the arsenal to fight postpartum hemorrhage (PPH). Vacuum-induced uterine tamponade uses negative pressure created inside the uterus to collapse the bleeding cavity, causing the muscle to close off the hemorrhaging vessels. The device represents another minimally invasive tool that is potentially translatable to developing countries with minimal resources.
9. Prostate Cancer PARP Inhibitors
Previously known for their success in treating women’s cancers, two PARP inhibitors, which block proteins that help repair damaged tumor DNA in people with BRCA1 and BRCA2 gene mutations, were approved for prostate cancer treatment in May. These pharmacological agents have been demonstrated to delay the progression of prostate cancer in men with refractory cancer and DNA repair pathway mutations.
10. Immunologics for Migraine Prophylaxis
New medications were developed in 2018 help head off migraine pain by blocking activity of the calcitonin gene-related peptide (CGRP) molecule, which spikes during these headaches. In 2020 this FDA-approved class of medication became the first actively prescribed therapeutic for preventative treatment of migraines, which affect an estimated 12% of the U.S. adult population.
More information about the these innovations, including videos and year-by-year comparisons is available on the website.
Mandy Roth is the innovations editor at HealthLeaders.
Gene therapy for treatment of hemoglobinopathies, genetic disorders responsible for sickle cell disease and thalassemia, topped the list of significant medical innovations.
Treatments for multiple sclerosis, cystic fibrosis, hepatitis C, infant respiratory distress syndrome, postpartum hemorrhage, prostate cancer, and migraines hold promise to improve patient outcomes.
Smartphone-connected implantable devices and telemedicine are the key technologies the healthcare system cited as innovations that will change treatment dynamics.