Cleveland Clinic unveils Top 10 Medical Innovations for 2021

• A gene therapy for blood disorders, new drugs for cystic fibrosis and greater access to telemedicine are among Cleveland Clinic’s Top 10 Medical Innovations for 2021.

Cleveland Clinic unveils Top 10 Medical Innovations for 2021

CLEVELAND – A promising gene therapy for blood disorders. A new class of drugs for cystic fibrosis. Greater access to telemedicine. These are some of the innovations that will improve healing and change healthcare in the coming year, according to a distinguished panel of doctors and researchers.

In conjunction with the 2020 Medical Innovation Summit, Cleveland Clinic announced the Top 10 Medical Innovations for 2021. Now in its 18th year, the annual Medical Innovation Summit will be hosted by Cleveland Clinic Innovations, Cleveland Clinic’s development and commercialisation arm.

The list of breakthrough technologies was selected by a committee of Cleveland Clinic subject matter experts, led by Will Morris, M.D., executive medical director of Cleveland Clinic Innovations, and Akhil Saklecha, M.D., managing director of Cleveland Clinic Ventures.

Here, in order of anticipated importance, are the Top 10 Medical Innovations for 2021:

1. Gene Therapy for Hemoglobinopathies

Hemoglobinopathies are genetic disorders that affect the structure or production of the haemoglobin molecule, the red protein responsible for carrying oxygen in the blood. The most common hemoglobinopathies include sickle cell disease and thalassaemia, which together affect more than 330,000 children born worldwide each year and more than 100,000 patients with sickle cell disease in the United States alone. The latest research on hemoglobinopathies has brought an experimental gene therapy that gives sufferers the potential ability to produce functional haemoglobin molecules, reducing the presence of sickled cells or ineffective red blood cells in thalassaemia to prevent associated complications.

2. New Drug for Primary Progressive Multiple Sclerosis

In people with multiple sclerosis (MS), the immune system attacks the protective fatty myelin sheath covering nerve fibres. This causes communication problems between the brain and the rest of the body that can result in permanent damage or deterioration and, eventually, death. Approximately 15 per cent of people with MS experience a disease subset known as primary progressive, characterised by gradual onset and steady progression of signs and symptoms. A new FDA-approved therapeutic monoclonal antibody with a novel target is the first and only MS treatment for the primary progressive population.

3. Smartphone-Connected Pacemaker Devices

Implantable devices such as pacemakers and defibrillators send electrical impulses to the chambers of the heart muscle to contract and pump blood around the body. They are used to prevent or correct arrhythmias: heartbeats that are irregular, too slow or too fast. Remote monitoring of these devices is an essential part of care. Traditionally, remote monitoring is carried out through a bedside console that transmits data from the pacemaker or defibrillator to the doctor. Although millions of patients have pacemakers and defibrillators, many lack a basic understanding of the device or how it works, and compliance with remote monitoring has been suboptimal. Bluetooth-enabled pacemaker devices can address these disconnects between patients and their cardiac treatment. Used together with a mobile app, these connected devices give patients a greater understanding of pacemaker health data and transmit health information to their doctors.

4. New Drug for Cystic Fibrosis

Today, more than 30,000 people in the United States live with cystic fibrosis (CF), an inherited condition characterised by thick, sticky mucus that clogs the airways and traps germs, leading to infections, inflammation and other complications. CF is caused by a defective cystic fibrosis transmembrane conductance regulator (CFTR) protein. A class of drugs called CFTR modulators corrects the protein’s action, but drugs developed before last year had only been effective in a subset of people with certain mutations. A new combination drug, approved by the FDA in October 2019, provides relief to patients with the most common CF gene mutation (F508 del), estimated to account for 90 per cent of people living with the disease.

5. Universal Hepatitis C Treatment

Classed as a “silent epidemic” by the CDC, hepatitis C has become a major public health problem in the United States. Hepatitis C virus infection can lead to serious and life-threatening health problems such as liver failure, cirrhosis and liver cancer. Without a vaccine against the virus, patients have been limited to medication, but many treatments come with adverse side effects or are only effective for certain genotypes of the disease. A newly approved fixed-dose combination drug has greatly improved hepatitis C treatment. With efficacy of more than 90 per cent for hepatitis C genotypes one to six, the therapy represents an effective option for a broader spectrum of patients.

6. Bubble CPAP for Improved Lung Function in Premature Babies

Low-weight, fragile babies born prematurely often require specialised care, including ventilation for those with infant respiratory distress syndrome (IRDS). For IRDS, babies are usually given surfactant during mechanical ventilation, a practice that can cause lasting lung injury in premature babies and contribute to the development of chronic lung disease. Unlike mechanical ventilation, b-CPAP is a non-invasive ventilation strategy that delivers continuous positive airway pressure to newborns to maintain lung volumes during exhalation. The oscillating, rather than constant, pressure plays a role in its safety and efficacy, minimising physical trauma and stimulating lung growth when delivered over a prolonged period.

7. Greater Access to Telemedicine through New Practices and Policy Changes

COVID-19 led to greater adoption of telemedicine practices as doctors needed to see patients online. An increasingly virtual care model and greater consumer adoption came about through fundamental policy changes at both government and provider level. Since March, state and federal regulators have moved quickly to reduce barriers to telehealth, understanding that these new tools can speed up access to care while protecting healthcare workers and community members. These measures opened the door to telehealth, enabling new programmes and the expansion of existing networks.

8. Vacuum-Induced Uterine Tamponade Device for Postpartum Haemorrhage

Characterised as excessive bleeding after giving birth, postpartum haemorrhage is a devastating complication of childbirth, affecting one to five per cent of women who give birth. Mothers who experience postpartum haemorrhage may require blood transfusions, drugs that can cause dangerous side effects, long and uncomfortable procedures, and even emergency hysterectomy with loss of fertility. Non-surgical interventions targeting the bleeding site have been limited to balloon devices that expand the uterus while compressing the bleeding site. But the newest advance is vacuum-induced uterine tamponade, a method that uses negative pressure created inside the uterus to collapse the bleeding cavity and make the muscle close the vessels. The vacuum-induced device represents another minimally invasive tool for doctors, treating the complication and providing a low-tech solution that is potentially transferable to low-resource developing countries.

9. PARP Inhibitors for Prostate Cancer

Approximately one in nine men will be diagnosed with prostate cancer in their lifetime. While there have been advances over the last decade, the disease remains the second leading cause of cancer death among men in the United States. PARP inhibitors (drug inhibitors for cancer treatment) block proteins called PARP that help repair damaged tumour DNA in people with BRCA1 and BRCA2 gene mutations. Although known for their success in women’s cancers, two PARP inhibitors have been shown to delay the progression of prostate cancer in men with refractory cancer and mutations in the DNA repair pathway. Both were approved for prostate cancer in May 2020.

10. Immunologics for Migraine Prophylaxis

Migraines affect more than 38 million people in the United States, approximately 12 per cent of the adult population. For some time, multi-purpose drugs such as blood pressure medications, antidepressants, anti-seizure drugs and Botox injections have been used to prevent attacks. However, as they were not developed specifically for migraines, these methods have had mixed results. In 2018, new drugs were developed to help prevent migraine pain. This class of drugs works by blocking the activity of a molecule called calcitonin gene-related peptide (CGRP), which spikes during a migraine. Actively prescribed in 2020, this new FDA-approved class of drug is the first designed specifically for preventive migraine treatment, marking a new era in migraine therapeutics.

At next year’s Medical Innovation Summit, in addition to the annual Top 10 list, Cleveland Clinic will present a new award honouring its rich history of innovation and advances in healthcare delivery. The inaugural award will go to a team, organisation or individual who has made a significant contribution to healthcare delivery with a focus on one or more defined areas. Details will be announced in early 2021.

For more information about the annual Top 10 Medical Innovations list, including descriptions, videos and year-by-year comparisons, visit: https://innovations.clevelandclinic.org/Programs/Top-10-Medical-Innovations/Top-10-for-2021.

About Cleveland Clinic

Cleveland Clinic is a nonprofit multispecialty academic medical centre that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based on the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S. News & World Report consistently names

Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Among Cleveland Clinic’s 67,554 employees worldwide are more than 4,520 salaried physicians and researchers, and 17,000 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties. Cleveland Clinic is a 6,026-bed health system that includes a 165-acre main campus near downtown Cleveland, 18 hospitals, more than 220 outpatient facilities, and locations in southeast Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2019, there were 9.8 million outpatient visits, 309,000 hospital admissions and observations, and 255,000 surgical cases throughout Cleveland Clinic’s health system. Patients came for treatment from every state and 185 countries.