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The Device Angle on Angiogenesis

This article was originally published in Start Up

Executive Summary

Ten years ago, researchers observed that injecting vascular endothelial growth factors or fibroblast frowth factors into animal models of ischemia stimulated the formation of new blood vessels. The discovery that, with a bit of prompting, the body's natural capacity for angiogenesis could be accelerated, has drawn more than a dozen drug firms and a handful of cardiovascular device companies into the search for a biological alternative that can aid or replace current cardiovascular interventions, or even delay the progression of heart disease.

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In heart failure, companies with expertise in gene or cell biology, or percutaneous delivery devices, see the first application where regenerative medicine could finally realize its promise. The enormous patient population, the high mortality of the disease, and the economics of treating it today provide a multi-billion dollar opportunity for which it's worth braving the complexity of cell therapy for tissue repair. Indeed, first-generation autologous heart cell therapies involve many different types of expertise resident in companies with different mindsets. Unknowns dog every component of the therapies on the level of basic biology. Still to be worked out: the right cell types; the optimal delivery route and device; when and at what dose cells should be administered, and in combination with which genes or drugs. Nevertheless, the great need in heart failure keeps companies dedicated to cardiac regeneration therapies. And as the cell therapy developers reveal new discoveries about the innate regenerative powers of the heart, drug developers are starting to move in, promising a much simpler approach than the combination products presently in the works.

Cardiac Gene Therapy: Combination Products' Next Frontier?

Orthopedic biomaterials and drug-eluting stents are only the first hint at the potentially transforming nature of combination products: device/biologic combination products that may bring a revolution to clinical therapy and to the device industry. In vascular medicine, catheter-based delivery of cardiac gene therapy may become a significant advance, yet with scant clinical evidence of efficacy and only anecdotal physician experience using catheter delivery systems, the field remains all promise. Many device executives think they see a path emerging, largely due to fundamental changes in the dynamics of their industry that are moving device business models closer to that of their pharma industry cousins.

Cardiac Gene Therapy: Combination Products' Next Frontier?

Orthopedic biomaterials and drug-eluting stents are only the first hint at the potentially transforming nature of combination products: device/biologic combination products that may bring a revolution to clinical therapy and to the device industry. In vascular medicine, catheter-based delivery of cardiac gene therapy may become a significant advance, yet with scant clinical evidence of efficacy and only anecdotal physician experience using catheter delivery systems, the field remains all promise. Many device executives think they see a path emerging, largely due to fundamental changes in the dynamics of their industry that are moving device business models closer to that of their pharma industry cousins.

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