Next generation mRNA vaccines. A new approach to treating prostate cancer. Novel therapy to lower LDL. These are three of the game-changing technologies set to transform healthcare in 2022, according to a panel of Cleveland Clinic physicians and researchers led byD.Geoffrey Vince, PhD, Executive Director of Innovations and Chair of Biomedical Engineering.
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"At the Cleveland Clinic, a shared passion for delivering world-class care and an embedded culture of innovation fuels ongoing dialogue to improve healthcare between our clinicians and researchers," said Dr. vince “As such, our experts always have their finger on the pulse when it comes to new technologies that will transform healthcare. The Top 10 Medical Innovations program was created to share their insights with the broader healthcare community, and year after year our professionals continue to successfully predict advances in devices, technologies and therapies.”
Here are the top 10 medical innovations for 2022, in order of their likely importance:
1.Next generation mRNA vaccinology. Advances in RNA generation, purification, and cellular delivery have enabled the development of RNA therapies for a wide range of applications, such as cancer and Zika virus. The technology is inexpensive and relatively easy to manufacture. In addition, the COVID-19 pandemic has shown that the world needs rapid development of a vaccine that can be easily deployed around the world. Based on previous research that laid the foundation for this technology, an effective COVID-19 vaccine was developed, manufactured, approved and deployed in less than a year. This landscape-changing technology has the potential to quickly and efficiently eliminate some of healthcare's toughest diseases.
2.PSMA-directed therapy. Each year, more than 200,000 Americans are diagnosed with prostate cancer - the most commonly diagnosed cancer in US men. Early detection and successful imaging are critical for tumor localization, disease staging, and detecting recurrences. Prostate-specific membrane antigen (PSMA), found at high levels on the surface of prostate cancer cells, is a potential biomarker of the disease. PSMA-PET uses a radioactive tracer to locate and bind to PSMA proteins, making them visible through PET imaging. This approach can be used in conjunction with CT or MRI scans to visualize where prostate cancer cells are located. In 2020, this technology received FDA approval based on Phase 3 studies that showed significantly higher accuracy in detecting prostate cancer metastases compared to traditional imaging using bone and CT scans.
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3.New treatment to lower LDL. High blood cholesterol levels, especially low-density lipoproteins (LDL-C), are major contributors to cardiovascular disease. In 2019, the FDA reviewed an application for inclisiran for the treatment of primary hyperlipidemia (including hereditary hypercholesterolemia) in adults with elevated LDL-C while on maximally tolerated dose statins. Inclisiran is an injectable, chemically synthesized small interfering RNA targeting the PCSK9 protein. Unlike statins, it requires infrequent dosing (twice a year) and when used in conjunction with statins, provides effective and sustained LDL-C lowering. Its lasting effects may help alleviate medication non-compliance, a major cause of failure to lower LDL-C levels. Inclisiran received FDA approval in December 2021 and is widely recognized as a game changer for patients with heart disease.
4.Novel drug for the treatment of type 2 diabetes. In the US, 1 in 10 people has diabetes. One potential therapy is a once-weekly injectable dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide receptor (GLP-1) agonist aimed at controlling blood sugar. Injected under the skin, GLP-1 and GIP receptors cause the pancreas to release insulin and block the hormone glucagon, limiting spikes in blood sugar after a meal. In addition, it slows down digestion, helping people stay full longer and eat less. Late phase 3 studies show that the treatment significantly reduces hemoglobin A1C in type 2 diabetes and aids in weight loss, potentially making it the most effective therapy developed for diabetes and obesity to date.
5.Breakthrough in the treatment of postpartum depression. Experts believe that the prevalence of postpartum depression may be at least double current statistics because many cases go undiagnosed. Counseling and antidepressants are primary treatments, but some women do not respond to these therapies. In 2019, the FDA approved an intravenous infusion regimen to specifically treat postpartum depression. This novel therapy, given 24 hours a day for 60 hours, uses a neurosteroid to control the brain's response to stress. This treatment design is groundbreaking because it targets signaling thought to be deficient in hormone-sensitive postpartum depression. Additionally, this treatment appears to show benefits very quickly, while traditional antidepressants typically take two to four weeks to show a significant effect. This quick treatment option would be a breakthrough for women with this often overlooked condition.
6.Targeted medication for hypertrophic cardiomyopathy. For decades, physicians have had limited effectiveness in treating patients' symptoms of hypertrophic cardiomyopathy (HCM). Non-specific medications are prescribed to treat some of the symptoms that HCM shares with other cardiovascular diseases. These therapies include beta-blockers, antiarrhythmics, calcium channel blockers, and anticoagulants. However, a new treatment is working to reduce the root cause of HCM in many patients. A top-of-the-line drug specifically targets the heart muscle to reduce abnormal contractions caused by genetic variants that push the heart into overdrive. By targeting this mechanism in HCM patients, this novel treatment not only improves symptoms and quality of life, but could potentially slow disease progression. The FDA has assigned a target date of April 28, 2022 for this therapy. If approved, it would be the first drug to treat HCM and bring new hope to patients and doctors.
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7.Non-hormonal alternatives forTReATING Hot flashes during menopause. More than 50% of menopausal women experience hot flashes, which can last an average of seven years. Hormone therapy is effective and safe when used properly, but it carries some risk. Also, not all patients are candidates for hormone therapy. Fortunately, a new group of non-hormonal drugs called NK3R antagonists have emerged as a viable alternative to hormone therapy. These drugs disrupt a signaling pathway in the brain that is involved in causing hot flashes. They have shown promise in clinical trials to relieve moderate to severe menopausal hot flashes as effectively as hormones. Although additional studies are needed to fully understand the efficacy and safety profile of these new drugs, it is clear that the next generation of non-hormonal treatments for menopausal hot flashes is on the horizon.
8.Implantable for severe paralysis. About 1 in 50 Americans, or 5.4 million people, has some form of paralysis. Although the cost of treatment is high, the value does not compare to the adverse effects on patients. Most patients with paralysis experience significant deterioration in their overall health. Recently, a team has given these patients new hope by using implanted brain-computer interface technology to restore lost motor control and allow patients to control digital devices. The technology uses implanted electrodes to collect movement signals from the brain and decode them into movement commands. It has been shown to restore voluntary motor impulses in patients with severe paralysis due to dysfunction of the brain, spinal cord, peripheral nerves or muscles. While the interface technology is still in its infancy, the FDA has called the implantable device a "breakthrough device," underscoring the need to bring this novel technology to the bedside of patients who need it most.
9.Artificial intelligence for early detection of sepsis. Sepsis is a leading cause of hospitalizations and deaths worldwide. Since septic shock has a very high mortality rate, early diagnosis of sepsis is crucial. Diagnosis can be complicated because early symptoms are nonspecific. Artificial intelligence (AI) has emerged as a new tool to quickly detect sepsis. Using AI algorithms, the tool detects several key sepsis risk factors in real time by monitoring patients' electronic medical records as doctors enter information. Flagging high-risk patients can help facilitate early intervention, which can improve outcomes, reduce healthcare costs and save lives.
10.Predictive Analytics & Bluthochdruck. Often referred to as the "silent killer," high blood pressure usually shows no symptoms while increasing the risk of serious health problems, including heart disease, heart failure, and stroke. There are effective treatment options. However, many adults are not aware that they have high blood pressure until they experience a significant health crisis. Using machine learning, a type of AI, doctors can choose more effective drugs, drug combinations, and dosages to improve high blood pressure control. AI will also enable physicians to predict cardiovascular morbidities and intervene before they occur. Predictive analytics can be the key to preventing high blood pressure and many other diseases.
For more information on the annual top 10 medical innovations, including descriptions, videos and year-on-year comparisons, visitInnovations from the Cleveland Clinic.