5 CV innovations bound to make an impact in 2020
Cleveland Clinic revealed its predictions for the top 10 medical innovations of 2020 on Oct. 23, naming five cardiovascular concepts in the process.
A CV innovation didn’t take the number-one slot for next year’s anticipated heavyweights—that was a recently FDA-approved dual-acting osteoporosis drug known as romosozumab—but half of Cleveland Clinic’s predictions had to do with cardiology. A panel of physicians and researchers led by Michael Roizen, MD, emeritus chief wellness officer at Cleveland Clinic, ranked the up-and-coming tech.
“Healthcare is ever-changing and we anticipate that these innovations will significantly transform the medical field and improve care for patients at Cleveland Clinic and throughout the world,” Roizen said in a release.
The team’s predictions were presented last week at the 2019 Medical Innovation Summit in Cleveland, Ohio. Innovations included romosozumab, a therapy to mitigate peanut allergies, closed-loop spinal cord stimulation, biologics in orthopedic repair and PARP inhibitors for maintenance therapy in ovarian cancer, as well as these potential cardiology game-changers:
Expanded use of minimally invasive mitral valve surgery
Coming in second on Cleveland Clinic’s list was the expanded approval of Abbott’s MitraClip device, which is used to treat mitral valve regurgitation (MR). Minimally invasive surgery for MR repair was initially introduced in 2013, but until this March the MitraClip was approved only for use in patients with primary MR. Now, it’s an option for patients with secondary MR and MR as a result of an enlarged left ventricle, allowing those patients symptom relief they haven’t been able to find in other therapies.
Inaugural medication for transthyretin amyloid cardiomyopathy
Cleveland Clinic defines transthyretin amyloid cardiomyopathy (ATTR-CM) as a “progessive, underdiagnosed, potentially fatal disease” in which amyloid protein fibrils deposit and stiffen within the walls of the heart’s left ventricle. But, after fast-track and breakthrough designations in 2017 and 2018, the FDA approved tafamidis—the first-ever drug designed to treat ATTR-CM—in May. Tafamidis made number three on Cleveland Clinic’s weighted list.
Antibiotic envelope for CIED infection prevention
Seventh on the list was an antibacterial envelope designed to cut the risk of infections after cardiac implantable electronic device implantation. While CIEDs like pacemakers and defibrillators are major mainstays in cardiology, infections can occur in up to 4% of CIED implantations and result in a 25% one-year mortality rate. The bioresorbable envelope, proven effective in the recently reported WRAP-IT trial, delivers two antimicrobial drugs over a period of seven days to reduce infections by 40%.
Bempedoic acid for cholesterol lowering in statin-intolerant patients
A potential alternative to statins made number eight on Cleveland Clinic’s list. Statins are the most popular drug prescribed to treat high LDL-cholesterol in the U.S., but they also cause muscle pain in 5-10% of users. Unlike statins, bempedoic acid, developed as a once-daily oral supplement to a patient’s existing medication regimen, can’t accumulate in muscle, reducing potential side effects. It helped patients reduce their LDL-C levels by an average of 25% in studies but hasn’t yet been approved by the FDA.
Drugs for heart failure with preserved ejection fraction
Coming in tenth on the list were SGLT2 inhibitors, a class of type 2 diabetes medications that are now being explored as a treatment option for HFpEF. SGLT2 inhibitors, which prevent the reabsorption of glucose in the kidneys, became a subject of interest after they were shown to reduce heart failure hospitalizations and CV death in patients with type 2 diabetes and those with heart failure with reduced ejection fraction (HFrEF) but no diabetes. Research is ongoing in patients with HFpEF, with an FDA decision expected in 2020.