Cleveland Clinic on Wednesday released its annual list of the top 10 medical innovations the health system predicts will "transform health care" in 2020.
The list was chosen by a panel of Cleveland Clinic scientists and physicians led by Cleveland Clinic's Chief Wellness Officer Michael Roizen. To compile the list, the panel selected innovations that they predict will "significantly transform the medical field and improve care for patients at Cleveland Clinic and throughout the world," according to Roizen.
The top innovation
The panel predicts that a dual-acting osteoporosis drug will be the most important innovation of 2020.
In April, FDA approved a dual-acting drug called romosozumab that helps prevent additional bone fractures among postmenopausal patients with osteoporosis and among osteoporosis patients who are intolerant to other therapies. The drug works by inhibiting the protein sclerostin, which blocks bone formation.
However, Hylton Joffe, director of FDA's Center for Drug Evaluation and Research's Division of Bone, Reproductive and Urologic Products, noted that could increase the risk of cardiovascular death. As such, he said that "it's important to carefully select patients for this therapy."
The other selected innovations, listed in order of predicted impact, are:
2. Expanded use of minimally invasive mitral valve surgery
About 10% of patients over age 75 have a defective mitral valve. Expanding approval to a minimally invasive valve repair device could help patients whose symptoms failed to respond to other therapies, the Cleveland Clinic team said.
3. First medication for treatment of transthyretin amyloid cardiomyopathy
FDA this year approved tafamidis, the first-ever medication for treatment of ATTR-CM, a potentially fatal, underdiagnosed cardiovascular disorder in which amyloid proteins stiffen the walls of the heart's left ventricle. FDA's approval of tafamidis marks "the first-ever medication for treatment of this increasingly recognized condition," according to the Cleveland Clinic team.
4. Therapy to reduce effect of peanut allergies
A new oral immunotherapy medication could gradually build tolerance to peanut exposure among people with severe peanut allergies, protecting the patients against the effects of an allergy attack.
5. Closed-loop spinal cord stimulation to treat chronic pain
Spinal cord stimulation, a common treatment for chronic pain, can often lead to unsatisfactory outcomes due to overstimulation or subtherapeutic events. But closed-loop spinal cord stimulation improves communication between the implanted device and the spinal cord, resulting in more relief from pain and fewer complications.
6. Biologics in orthopedic repair.
The body can take months or years to recover from orthopedic surgery, the Cleveland Clinic team noted, but the advent of biologics in the field can help reduce recovery from these procedures. Biologics, the team wrote, "have the power to replace or harness the body's own power and promote healing."
7. Antibiotic-embedded envelopes for infection prevention
Antibiotic-embedded envelopes encase themselves around cardiac devices, helping to prevent potentially life-threatening infections and complications among the 1.5 million patients who receive implantable cardiac electronic devices each year.
8. Bempedoic acid to lower cholesterol in statin intolerant patients
Most U.S. adults with high cholesterol manage the condition with statins, but statins can cause bad side effects, such as muscle pain. Bempedoic acid can serve as an alternative treatment for the condition without the side effects, the team noted.
9. Poly-ADP ribose polymerase inhibitors for maintenance therapy in ovarian cancer
Poly-ADP or PARP inhibitors are "one of the most recent important advances [in] ovarian cancer treatment," according to Cleveland Clinic. The inhibitors "block repair of damaged DNA in tumor cells," which can increase cell death in tumors. The inhibitors, which are undergoing large-scale trials, have improved progression-free survival, the Cleveland Clinic team noted.
10. Diabetes drugs to treat heart failure
Researchers are exploring using SGLT2 inhibitors, which are commonly used to treat Type 2 diabetes, to treat heart failure with preserved ejection fraction (HFpEF), also known as diastolic heart failure (Drees, Becker's Health IT & CIO Report; 10/23; Brooks, Medscape, 4/9; Roth, HealthLeaders Media, 10/24).