Top 10 Medical Innovations for 2020 Revealed

A dual-acting osteoporosis drug. Minimally invasive mitral valve surgery. A new treatment for peanut allergies. These are three of the innovations that will change healthcare in 2020, according to a panel of Cleveland Clinic physicians and scientists led by Emeritus Chief Wellness Officer Michael Roizen, MD.

The Top 10 Medical Innovations of 2020 were announced as the culminating event of Cleveland Clinic’s 17th annual Medical Innovation Summit, held in Cleveland, October 21-23, 2019.

Here they are, in order of anticipated importance:

1. Dual-Acting Osteoporosis Drug

With osteoporosis, bones become weak, brittle and at risk of breaking. Bone loss occurs silently and progressively — often without symptoms until the first fracture. But now there’s a new way to increase bone strength. The FDA recently approved a dual-acting drug (romosozumab), which can help patients with osteoporosis prevent 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 people over age 75, the mitral valve is defective, causing regurgitation. Expanding the approval of a minimally invasive valve repair device to patients who have failed to get symptom relief from other therapies provides an important new treatment option.

3. Inaugural Medication 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, tafamidis received FDA approval in 2019. It’s the first-ever medication for treatment of this increasingly recognized condition.

4. Therapy for Mitigation of Peanut Allergies

It’s a terrifying reality for 2.5% 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, it is not enough to quell the ever-present anxiety. A new oral immunotherapy medication to gradually build tolerance to peanut exposure may improve protection.

5. Closed-Loop Spinal Cord Stimulation

Chronic pain is a frustrating condition, and a large reason for prescribing opioid medication. Spinal cord stimulation is another popular treatment option for chronic pain. An implantable device provides electrical stimulus to the spinal cord. However, unsatisfactory outcomes due to subtherapeutic or overstimulation events are common. Closed-loop stimulation allows for better communication between the device and the spinal cord, optimizing stimulation and pain relief.

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 now can 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% of adults in the U.S. Left untreated, the condition could lead to serious health problems like heart attack and stroke. Statins are the typical treatment, but they cause unacceptable muscle pain in some people. Bempedoic acid provides another way to lower LDL-cholesterol while avoiding these side effects.

9. PARP Inhibitors for Maintenance Therapy in Ovarian Cancer

Poly (ADP-ribose) polymerase (PARP) inhibitors block the repair of damaged DNA in tumor cells, increasing cell death, especially in tumors with deficient repair mechanisms. One of the most recent advances in 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

In heart failure with preserved ejection fraction (HFpEF) — also known as diastolic heart failure —ventricular heart muscles contract normally but do not relax as they should. The heart is unable to properly fill with blood, leaving less blood to be pumped out to the body. Currently, treatment recommendations are directed at accompanying conditions and mere symptom relief. But SGLT2 inhibitors, a class of medications used to treat type 2 diabetes, is now being explored in HFpEF — alluding to a potential new treatment option.

For more on the annual Top 10 Medical Innovations, including descriptions, videos and year-by-year comparisons, visit Cleveland Clinic Innovations.