October 23, 2019 /
Cleveland Clinic Unveils Top 10 Medical Innovations for 2020
A panel of top doctors and researchers presents the medical advancements with the power to transform healthcare in the next year
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dual-acting osteoporosis drug. Minimally invasive mitral valve surgery.
New treatment for peanut allergies. These are some of the innovations
that will enhance healing and change healthcare in the coming year,
according to a distinguished panel of doctors and researchers.Cleveland Clinic today announced the Top 10 Medical Innovations for 2020 at a multimedia presentation that capped off the 2019 Medical Innovation Summit. Now in its 17th year, the annual Medical Innovation Summit is organized by Cleveland Clinic Innovations, the development and commercialization arm of Cleveland Clinic.
The list of up-and-coming technologies was selected by a panel of Cleveland Clinic physicians and scientists, led by Michael Roizen, M.D., Emeritus Chief Wellness Officer at Cleveland Clinic.
“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,” said Dr. Roizen.
Here, in order of anticipated importance, are the Top 10 Medical Innovations for 2020:
1. Dual-Acting Osteoporosis Drug
Osteoporosis is a condition in which bones become weak and brittle, effectively increasing their risk of breaking. With osteoporosis, the loss of bone occurs silently and progressively – often without symptoms until the first fracture. Providing more bone-strengthening power, the recent FDA approval of a new dual-acting drug (romosozumab) is giving patients with osteoporosis more control in preventing additional fractures.2. Expanded Use of Minimally Invasive Mitral Valve Surgery
The mitral valve allows blood flow from the heart’s left atrium to the left ventricle. But in about 1 in 10 individuals over the age of 75, the mitral valve is defective causing the action of regurgitation. Expanding the approval of a minimally invasive valve repair device to a population of patients who have failed to get symptom relief from other therapies provides an important new treatment option.3. Inaugural Treatment for Transthyretin Amyloid Cardiomyopathy
A disheartening cardiovascular disorder, ATTR-CM is a progressive, underdiagnosed, potentially fatal disease in which amyloid protein fibrils deposit in, and stiffen, the walls of the heart’s left ventricle. But a new agent to prevent misfolding of the deposited protein is showing a significantly reduced risk of death. Following Fast-Track and Breakthrough designations in 2017 and 2018, 2019 marked the FDA approval of tafamidis, the first-ever medication for treatment of this increasingly recognized condition.4. Therapy for Peanut Allergies
It’s a terrifying reality for 2.5 percent of parents – the possibility that at any moment, their child might be unable to breathe due to an allergic reaction. Though emergency epinephrine has reduced the severity and risk of accidental exposure, these innovations are not enough to quell the ever-present anxiety. But development of a new oral immunotherapy medication to gradually build tolerance to peanut exposure holds the opportunity to lend protection against attack.5. Closed-Loop Spinal Cord Stimulation
Chronic pain is a terribly frustrating condition, and a large reason for prescription of opioid medication. Spinal cord stimulation is a popular treatment for chronic pain through which an implantable device provides electrical stimulus to the spinal cord. But unsatisfactory outcomes due to subtherapeutic or overstimulation events are common. Closed-loop stimulation is allowing for better communication between the device and the spinal cord providing more optimal stimulation and relief of pain.6. Biologics in Orthopaedic Repair
After orthopaedic surgery, the body can take anywhere from months to years to recover. But biologics – cells, blood components, growth factors, and other natural substances – have the power to replace or harness the body’s own power and promote healing. These elements are finding their way into orthopaedic care, allowing for the possibility of expedited improved outcomes.7. Antibiotic Envelope for Cardiac Implantable Device Infection Prevention
Worldwide, roughly 1.5 million patients receive an implantable cardiac electronic device every year. In these patients, infection remains a major, potentially life-threatening complication. Antibiotic-embedded envelopes are now made to encase these cardiac devices, effectively preventing infection.8. Bempedoic Acid for Cholesterol Lowering in Statin Intolerant Patients
High cholesterol is a major concern for nearly 40 percent of adults in the U.S. Left untreated, the condition could lead to serious health problems like heart attack and stroke. Though typically managed with statins, some individuals experience unacceptable muscle pain with statins. Bempedoic acid provides an alternative approach to lowering of LDL-cholesterol while avoiding these side effects.9. PARP Inhibitors for Maintenance Therapy in Ovarian Cancer
PARP, or poly-ADP ribose polymerase, inhibitors block repair of damaged DNA in tumor cells which increases cell death, especially in tumors with deficient repair mechanisms. One of the most recent important advances ovarian cancer treatment, PARP inhibitors have improved progression-free survival and are now being approved for first-line maintenance therapy in advanced stage disease. Several additional large-scale trials are underway with PARP inhibitors set to make great strides in improving outcomes in cancer therapy.10. Drugs for Heart Failure with Preserved Ejection Fraction
Heart failure with preserved ejection fraction (HFpEF) – also known as diastolic heart failure – is the condition in which the ventricular heart muscles contract normally, but do not relax as they should. With preserved ejection fraction, the heart is unable to properly fill with blood – leaving less available to be pumped out to the body. Currently, recommendations for this treatment are directed at accompanying conditions and mere symptom relief. But SGLT2 inhibitors, a class of medications used in the treatment of type 2 diabetes, is now being explored in HFpEF – alluding to a potential new treatment option.For more information on the annual Top 10 Medical Innovations including descriptions, videos, and year-by-year comparisons visit: https://innovations.clevelandclinic.org/Summit/Top-10-Medical-Innovations
Kanika Juneja (right)
It started towards the end of September. My body had been getting tired
faster and I was experiencing spells of dizziness. I'd told my parents,
who, in their wisdom, thought it was my diet and advised me to eat
better and exercise more. Still, the feeling of dizziness persisted, and
I finally visited a doctor, only to be told the same things that my
parents suggested, “You'll be fine, just eat better.”
A few days later, on October 2, 2014, I was sleeping over at my best
friend, Richa's home. We'd been out with friends, and by the time we got
to her house, I was feeling extremely nauseous and dizzy. I finally
slept, only to realise that upon waking up I kept getting bites on the
inside of my cheeks (my teeth were involuntarily biting the inside of my
cheeks). The symptoms, even then, were so little, that my parents and I
didn't think of them as serious, at all.
Three days later, I felt this odd feeling in my leg that wouldn't go
away. I couldn't describe it even to doctors and attendants, who we'd
visited, after I insisted that I was in discomfort.
This time, my doctor, seemed a bit perplexed, and worried, by my
symptoms of cheek bites, numbness, and this uncomfortable and odd
sensation in my legs.
Kanika and her mother
The morning after I was admitted to AIIMS, a full panel of doctors came
to ascertain my condition. They were worried about what my MRI showed,
and wanted to conduct further tests. In the middle of their discussion, I
had to go use the toilet, so I excused myself.
Multiple sclerosis is an autoimmune disease for which there is no known
cure. It involves the immune system misfiring and attacking the neurons
in the brain, which causes the organs not to receive the signals sent by
the brain.
This time, when the doctor entered my room, he looked visibly concerned.
All around me, friends were getting jobs, going abroad and a few were
even marrying, but I, who was an overachiever all throughout school, who
enjoyed theatre and public speaking, was confined to a bed with the
destiny of staying there.
I started taking the MS injections upon going back home. The injections
came with a host of side effects, extreme weakness, rashes over my body,
nausea, and dizziness. The doctor advised me to always self-administer
(they had a specific placing and schedule) them on Friday, so I had the
entire weekend to recover from the injections.
In October 2016, my luck changed, I found out about Hematopoietic stem
cell transplantation (HSCT). It meant removing stem cells from the body,
undergoing chemotherapy so that the immune system that had gone haywire
would reset, and then reintroducing the stem cells so that the body
could heal. It was a very new research based treatment that had given
some very positive results in places like Russia, Chicago, Philippines,
and Mexico. It was capable of stopping the progression of the disease,
so in my case, where there was very little permanent disability, it was
virtually a cure.
I found out, that doctors didn't prescribe this treatment until the MS
patient was at the last tethers of facing extreme disability or death.
However, I felt it unfair.
In December 2016, I had my eggs frozen, as chemotherapy radiation could
cause me to go infertile. And then, after going through months of
testing, in January 2017, I underwent AHSCT, which is Autologous
hematopoietic stem cell transplantation, 'autologous' meaning that I
used my own stem cells.
I underwent the removal of stem cells, the chemotherapy, then the stem
cells were reintroduced (that hurt the most), and I was kept in
isolation for the duration because my immune system was practically
non-existent.
Thankfully, I have, so far, been free from symptoms of MS since my
transplant. I have also had no need to take my medicines or injections.
Things that I used to take on a daily basis.
I am, also, on a mission to spread awareness about how MS is a 'hidden
disease' with no physical indicators and therefore largely ignored. It
occurs mostly in women, from whom weakness is expected, and therefore
undiagnosed. MS is also considered a disease that affects the brain and
spine, which is misunderstood as a mental illness. None of these are
true, and for those who suffer from it, there is a cure. I run this 
Kanika Juneja (now)
I have a set of tests in December 2017, to ascertain the status of my
disease. Meanwhile, I wanted to be a lecturer, but I realised I'm better
at interacting with adults, so maybe I will become an adult trainer. It
all depends on my results, so fingers crossed.
As told to Tanvi Jain
All images sourced via Kanika Juneja