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The 10 Biggest Medical Innovations For 2021 According to Cleveland Clinic

World-leading clinicians and researchers unveil ground-breaking medical advances and introduce a new prize for innovation in healthcare.

The annual Medical Innovation Summit, organised by Cleveland Clinic Innovations, the development and commercialization division of Cleveland Clinic, is now in its 18th year and has served as a key platform for the introduction of the 10 biggest medical innovations for 2021. 

From gene therapy for blood diseases to increased access to telemedicine to a new class of cystic fibrosis drugs, the list of cutting-edge technologies was selected and presented by a Cleveland Clinic expert panel led by Dr. Will Morris, Executive Medical Director of Cleveland Clinic Innovations, and Dr. Akhil Saklecha, Managing Director of Cleveland Clinic Ventures.

Listed below are the 10 biggest medical innovations for 2021 in their estimated order of importance:

1. Gene therapy for haemoglobinopathies

What are haemoglobinopathies?

Haemoglobinopathies are genetic disorders that affect the structure or production of the haemoglobin molecule – the red protein responsible for transporting oxygen in the blood. The most common haemoglobinopathies include sickle cell disease and thalassaemia.  Together, these disorders affect more than 330,000 children born each year worldwide. Sickle cell disease affects more than 100,000 patients in the United States alone.

An experimental gene therapy has been developed as a result of the latest research into haemoglobinopathies. This therapy should enable affected people to create functional haemoglobin molecules that will reduce the presence of sickle blood cells or red blood cells that are ineffective in cases of thalassaemia. In this way, it will be possible to prevent the complications associated with these disorders.

2. New drug for primary progressive multiple sclerosis

Multiple sclerosis (MS) is an autoimmune disease in which the immune system attacks the protective fatty myelin sheath that covers nerve fibres. This attack leads to communication problems between the brain and the rest of the body, often resulting in permanent damage, deterioration and ultimately death.

About 15% of people with MS develop a primary progressive form of the disease. This subset of the disease is characterised by progressive development and a steady progression of signs and symptoms. A new therapeutic monoclonal antibody approved by the FDA with a novel target is the first and only treatment for MS in the primary-progressive MS population.

3. Smart pacemakers

Used to prevent or correct arrhythmias, pacemakers and defibrillators deliver electrical impulses to the chambers of the heart muscle to contract and pump blood to the body. Traditionally, these implanted devices allow remote monitoring through a console at the bedside that transmits data to the doctor in charge of care. Although millions of patients use these devices, many still lack a basic understanding of how they work. Connecting these devices to an application available on patients’ smartphones will allow them to gain a better understanding of their cardiac treatment while transmitting valuable data to their doctors.

4. New drugs for cystic fibrosis

Cystic fibrosis, a hereditary disease that affects more than 30,000 people in the United States, is characterised by thick, sticky mucus that obstructs the airways and traps germs, leading to infections, inflammation and other health complications.

Caused by a defective transmembrane conductance regulatory protein (CFTR), people affected by this disease must try to stay away from others to limit their exposure to potentially fatal germs. Until last year, the drugs available for the disease were only effective in people affected by certain mutations. A new combination of drugs approved by the FDA in October 2019 has proven to be effective in people with F508 del, the most common mutation in the CF gene, which accounts for approximately 90% of people with the disease.

5. Universal treatment of hepatitis C

Hepatitis C, described by the CDC as a “silent epidemic”, is one of the biggest public health concerns in the United States. People infected with the virus face serious risks, including cirrhosis, liver failure and liver cancer, all of which can be life-threatening. There are drugs available to treat the condition, but so far they have proven ineffective on some genotypes of the disease or come with undesirable side effects. A new FDA-approved treatment option, a fixed-dose combination of drugs, has been shown to be more than 90% effective in treating hepatitis C genotypes 1 to 6, which means that this new treatment is an effective option for a larger number of patients.

6. Non-invasive CPAP for improved lung function in premature babies

Premature babies are often exposed to a range of risks, particularly respiratory risks. Premature babies suffering from Infantile Respiratory Distress Syndrome (IRDS) are most often administered a surfactant during mechanical ventilation. This practice has the potential to cause long-term lung damage and is a major contributor to the development of chronic lung disease. b-CPAP: a new method of non-invasive ventilation has been developed to deliver continuous positive airway pressure to newborns to maintain lung volume during exhalation. Rather than applying constant pressure to the infant, b-CPAP applies oscillating pressure that reduces physical trauma while stimulating lung growth when administered over a long period of time. Ensuring safe and effective treatment of respiratory syndromes in infants.

7. The rise of telemedicine through new practices and policy changes

One of the challenges brought about by the pandemic has been the need to transform medical visits to ensure the safety of patients and doctors. This has been addressed by the increasing use of telemedicine. Virtual care is gradually becoming common practice following a change in policy at government and provider level to ensure increased consumer uptake.

Recognising the importance of these new tools, state and federal regulators have moved quickly to remove regulatory barriers to telemedicine. These measures have enabled the new practice to develop new programs as well as expand existing networks.

8. Novel device for postpartum haemorrhage

Postpartum haemorrhage affects one to five per cent of women giving birth. Characterised by excessive bleeding after the birth of the child, the complication may require blood transfusions, administration of drugs with dangerous side effects, lengthy and uncomfortable procedures and may even lead to an emergency hysterectomy resulting in loss of fertility. Until now, non-surgical interventions targeting the site of bleeding have been limited to balloon devices that dilate the uterus while compressing the bleeding site. The new approach to postpartum haemorrhage is vacuum-induced uterine tamponade. This method uses the negative pressure created inside the uterus to collapse the bleeding cavity, causing the muscle to close the vessels. This low-tech innovation could save the lives of women all over the world, especially in developing countries where access to resources is often limited.

9. PARP inhibitors for prostate cancer

Over the past decade, progress has been made in the diagnosis and treatment of prostate cancer. With one in nine men diagnosed with the disease during his lifetime, it remains the second leading cause of cancer death among men in the United States.

Pharmacological inhibitors, known for their success in women’s cancer, block proteins called PARPs that help repair damaged tumour DNA in people with mutations in the BRCA1 and BRCA2 genes. Two of them have been shown to delay the progression of prostate cancer in men with refractory cancer and mutations in the DNA repair pathway. In May 2020, both were approved for the treatment of the disease.

10. New medicines specifically targeting migraines

Usually treated with multi-purpose medications such as high blood pressure medication, antidepressants, anti-convulsion drugs and Botox injections, migraine attacks affect more than 38 million people in the United States, or 12% of the population. These methods, while effective in some cases, do not provide a concrete solution to help relieve migraine pain. In 2018, new drugs have been developed specifically targeting this condition. By blocking the activity of a molecule called calcitonin gene related peptide (CGRP), which reaches its peak during a migraine, this class of drugs is now approved by the FDA. Currently actively prescribed, this new class of drugs represents a major breakthrough in the treatment of migraines.

At next year’s Medical Innovation Summit, Cleveland Clinic will also introduce a new award in honour of its rich history of innovation and progress in healthcare provision. 

Details of the inaugural award will be published in early 2021. However, we already know that it will be awarded to a team, individual or organisation that has made a significant contribution to the healthcare sector in one or more defined areas.

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