Irish medical technology will transform the healthcare sector – The Irish Times

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Technologies developed in Ireland are expected to transform the treatment of hard-to-treat solid tumours, painful osteoarthritis and debilitating pelvic health conditions such as overactive bladder.

The projects are funded by the government’s Disruptive Technology Innovation Fund (DTIF) and Enterprise Ireland.

Tumors

Since the 1960s, cancer survival rates have improved dramatically, thanks to advances in medicine. However, most of the gains have been made in blood cancers, with many solid tumors still incurable.

In this context, the development of an Irish technology capable of providing precision therapy, adapted to the needs of an individual and capable of breaking the defenses of solid tumors, is welcome.

Dublin-based Remedy Biologics, together with TCD, NUI Galway and aCGT Vector, Drogheda, received €6.8 million from DTIF to achieve this.

Remedy CEO Dan Crowley explains that the goal is to find out how the immune system, at the level of a cell, interacts with a disease.

“We focus on the biology of disease and what the immune system does in response to disease,” says Crowley.

Professor Paul Leonard, Scientific Director of Remedy, is Assistant Professor of Biomedical Sciences at Dublin City University.

Leonard has been interested in developing new technologies that can overcome the many inefficiencies in the way drug discovery is performed.

At the level of a cell, Leonard says, everyone’s disease is different, and how that person’s immune system responds is also different.

“I’m interested in finding out which part of the immune system is appropriate to fight an individual’s disease,” Leonard says.

“We’re looking at which cells are functioning when disease is present,” says Leonard. The goal is to tap into the disease-fighting capacity that exists within each of us and release it upon the disease.

“To use an analogy, we take really good athletes and we turn them into Olympic athletes,” says Leonard.

It involves looking at individual cells and how they respond to disease – solid cancers in this case – in thousands of patients.

“We want to develop off-the-shelf therapies that will improve a person’s treatment for their disease,” Leonard says.

Only about one in five people have a good response to drug therapy, he says, and he would like to see that figure rise to four or even five out of five.

To do this, Leonard knows he needs to better understand the biology of how disease can disrupt an individual’s immune system.

Tumors are good at deactivating immune cells that can kill them, he says, and Remedy wants those cancer killers to work again.

Once an immune response can be elicited against a disease, even if initially weak, it can elicit an additional and stronger immune response.

“It’s like putting kindling on a fire, but the wood is a little wet, so it’s hard to get to,” Leonard says. “But once you light it, the fire is strong and it’s like a really strong immune response.”

Remedy is focused on using its new technology – called the Non-Reactive Platform – to fight lung and gastrointestinal cancer.

However, he expects this approach to work for other cancers, including a wide range of hard-to-treat solid cancers.

In the process, it can help change the way cancer is viewed.

“Instead of thinking about it [cancer] as a location in the body, we think about it because of its immune profile,” says Crowley, who aims to begin clinical testing of the technology in 18 to 24 months.

Bowl

It can take two and a half years for someone with pelvic health issues to see a specialist, and it’s the same all over the world, says Brendan Staunton, co-founder and CEO of Amara Therapeutics.

“We have identified a major problem with providing frontline treatment for people with pelvic problems,” says Staunton.

People who see a doctor for pelvic health issues quite often are prescribed medication on a speculative basis and without a diagnosis, he says, or are sent for surgery.

Amara received funding from the Enterprise Ireland commercialization fund to develop a digital solution.

Common pelvic health problems are stress urinary incontinence, organ prolapse, and overactive bladder.

Staunton had noted that software, in the form of apps, was being developed in the United States for conditions in which patients could benefit from non-drug behavioral interventions.

The FDA has, for example, approved several apps, or digital therapies, for people with diabetes, insomnia, and IBS.

“Many people don’t get behavioral therapy, even though science shows it’s equivalent or superior to medication,” Staunton says of pelvic health issues.

In the United States, a patient with prediabetes may be prescribed an app to guide them through a 12-16 week procedure,” says Staunton.

There are now at least seven such FDA-approved apps, he says, and it’s become a real and effective way to treat patients.

Amara has developed its own digital therapy, or app, called RiSolve for overactive bladder, which affects 52 million people in the US and EU.

“People have the urge to go to the bathroom, don’t make it in time, and have a bout of incontinence,” Staunton says.

The app is designed to reduce incontinence-related anxiety and guide patients through a cognitive behavioral therapy program.

“We built this eight-week intervention,” says Staunton. “It’s video and audio content, and the idea is that we teach them everything about their condition: what are the causes and what are the treatments.”

“They get educational videos every week and get tasks and challenges that they have to complete.”

Amara conducted a trial of the app at University Hospital Galway, with 18 patients. Of these, 100% reported a reduction in symptoms after the eight weeks, while 83% said their quality of life had improved.

Algorithms developed by Amara act as questionnaires, which collect data from patients using the app which can be sent to the doctor.

The clinician can use this data to give an indicative diagnosis, and based on this, behavioral intervention via the app is suggested.

Amara aims to be the world’s leading provider of digital behavioral therapies for neurological and gynecological conditions.

Osteoarthritis

As anyone with knee osteoarthritis will confirm, it is a painful and debilitating condition that impacts quality of life.

Relevium, a biopharmaceutical start-up from Galway, along with NUIG and HiTech Health, have been awarded €7 million to develop a new treatment for osteoarthritis of the knee using a hydrogel-based painkiller.

In Ireland, some 250,000 people suffer from this form of arthritis, including 14 million in the US and 18 million in the EU.

There are several steroid medications that offer fast pain relief, but a price must be paid in terms of cartilage damage.

There are also injectable hyaluronic acid products on the market, which produce variable results, with stem cell solutions far removed.

Relevium conducted preclinical testing at NUIG of a new product called Hydrobloc, which is different from existing therapies.

“We’ve started to get some really good data,” says Dr. Alison Liddy, co-founder of Relelvium and lead researcher on Hydrobloc.

Liddy and a research group from Professor Garry Duffy’s lab initially looked for a peptide molecule that could reduce the ability of nerve cells to signal pain.

They found a peptide that did the trick, 315Y. The next task was to determine how to introduce the molecule into the diseased knee.

Liddy decided to link the peptide to hyaluronic acid in gel form because it could hold the peptide in place in the joint and was already FDA-approved as a treatment for knee osteoarthritis.

“He ticked all the boxes,” says Liddy. “The molecule breaks down in the joint and the fragments block nerve fibers in the knee joint – we believe it also enters the subchondral bone.

“The biggest thing is pain relief and joint lubrication,” says Liddy. “It blocks all pain points – inflammatory and nerve pain.”

The aim is to provide pain relief and joint lubrication for six months, and two injections per year to fully manage the disease.

Liddy does not expect Hydrobloc to be available until 2029, as it is a drug and will undergo all necessary clinical trials.

Liddy says the product could also prove effective for osteoarthritis hips and painful bladder syndrome in women.


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