Medical innovations for 2021

The following 10 medical innovations are anticipated to make a significant difference in medical care in 2021. They were recently announced at the Cleveland Clinic’s 2020 Medical Innovation Summit. In its 18th year, the summit is organized by Cleveland Clinical Innovations, the clinic’s development and commercialization arm. 

Gene therapy for genetic disorders of the hemoglobin, including sickle cell disease and thalassemia. The experimental gene therapy provides the potential ability to make functional hemoglobin molecules, thereby reducing the presence of disordered or ineffective red blood cells.

Novel drug for primary-progressive multiple sclerosis
A new FDA-approved monoclonal antibody (ocrelizumab) is a first and only treatment for the 15% of MS patients who suffer from an MS disease subset known as “primary-progressive.” Monoclonal antibodies are laboratory-made proteins mimicking the immune system’s ability to fight off invading substances (antigens).

Smartphone-connected pacemaker devices
Remote monitoring of pacemakers and defibrillators by patients and their physicians becomes a reality with Bluetooth-enabled devices transmitting the health information in conjunction with a mobile app.

New medication for cystic fibrosis
A new combination drug of four cystic fibrosis transmembrane conductance regulators (CFTR) provides relief to the buildup of sticky, thick mucus in the lungs in 90% of individuals who are living with the malfunctioning protein made by the CFTR gene (F508 del). 

Universal hepatitis C treatment
A new combination medication provides therapy for a wider scope of patients with hepatitis C. With no vaccine for the virus, until now patients were limited to medications that were effective for only certain genotypes of the disease, or caused adverse side effects. 

Bubble CPAP for increased lung function in premature babies
Unlike mechanical ventilation of underweight and frail babies born prematurely with infant respiratory distress syndrome, bubble continuous positive airway pressure is established for spontaneously breathing newborns. Blended and humidified oxygen is delivered with binasal prongs (or nasal masks) with the distal end of the tubing immersed in water so that the gas bubbling through adjustable water depths prevents excess pressure at expiration. This method also prevents lasting lung injury that may be caused by the use of surfactants during mechanical ventilation.

Increased access to telemedicine
It took a virus to push governments and medical regulatory bodies to open the floodgates for telemedicine and telehealth, which has been embraced by clinicians, public health specialists, and the public. New virtual models in health care will continue to emerge well beyond the current needs of the pandemic.

Vacuum-induced uterine tamponade device for postpartum hemorrhage
The device is a medical-grade silicon tube with perforations in an elliptical loop on the intrauterine (distal end) and a vacuum connector at the proximal end, with a donut-shaped cervical seal. To collapse the bleeding uterine cavity, negative pressure is created inside the uterus with this vacuum-inducing device, thus causing the muscles to close off the vessels. This minimally invasive device is also translatable to developing countries with low resource availability.

PARP inhibitors for prostate cancer
PARP (poly ADP ribose polymerase) is an enzyme that both healthy cells and cancer cells use to repair damage in their DNA, but several forms of cancer cells, including those in prostate cancer, are more dependent on PARP for repairs than regular cells. Chemotherapy and radiation therapy attempt to kill cancer cells by inducing a high level of DNA damage. By inhibiting PARP’s repair function on the DNA by a group of PARP inhibitors, the effectiveness of chemo and radiation therapies may be enhanced. PARP inhibitors have been known for their success in women’s cancers; now two PARP inhibitors have been demonstrated to delay progression of prostate cancers as well. 

Immunologics for migraine prophylaxis
A new FDA-approved class of medications, specifically designed for the preventive treatment of migraines, work by actively blocking the activity of a calcitonin gene-related peptide (CGRP) molecule, which spikes during a migraine. The new medicines are monoclonal antibodies that counter or interfere with very specific parts of the CGRP. The medicines (erenubab, fremanezumab, and galcanezumab) are administered by monthly injections. Trials have shown significant reduction of migraine days in chronic sufferers. Side effects were mostly injection site reactions. 

This list of emerging medical innovations was selected by a panel of Cleveland Clinic physicians and scientists. I found it very enlightening that the 10 innovations came from four different sources: 
•    Complex social change (#7) 
•    Clever technical inventions (#3,6,8) 
•    Genetical manipulation (#1 ) 
•    Inspired molecular pharmacology and immunologics (#2,4,5,9,10)

For additional information about each innovation visit
—George Szasz, CM, MD

This post has not been peer reviewed by the BCMJ Editorial Board.

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