Vandana Iyer, Research Director, and Priyanka Jain, Senior Research Analyst, TechVision Practice, Frost & Sullivan
There is a rising global prevalence of non-communicable diseases (NCDs), and these account for 41 million annual global deaths (74%). Cardiovascular diseases (CVDs), cancers, chronic respiratory diseases, and diabetes alone account for over 80% of premature NCD deaths.
According to the World Health Organization (WHO) survey conducted in 2019, approximately 77% of deaths in UAE were due to NCDs. Of these, CVDs contributed 40% of deaths, cancer contributed 12%, diabetes and chronic respiratory disease contributed 5% each, and other NCDs contributed 15%.
Moving toward precision diagnosis and personalised treatment
Precision testing is crucial for diagnosing and treating cardiovascular disorders and involves biomarker analysis, imaging, and genetic profiling. It helps medical professionals maximise treatments, improve patient outcomes, and reduce the burden of cardiovascular illnesses on patients and healthcare systems. Predictive models guide early intervention and long-term preventative treatments, while pan-omics improves CVD precision diagnosis, leading to better patient outcomes. Active research is going to explore novel biomarkers that could contribute to precise and early diagnosis of CVD. Innovations around Liquid Biopsy and blood-based tests aid in identifying CVD-specific biomarkers.
Liquid biopsy is a valuable method for CVD early identification, risk assessment, and treatment monitoring. Biomarkers like troponins, microRNAs, and circulating cell-free DNA are used to evaluate gene expression, cardiovascular stress, and heart damage, while genetic testing can distinguish between polygenic and monogenic CVDs.
Blood tests quantify biomarkers and patient data, enabling personalised treatment. US-based companies like Cardio Diagnostics, Prevencio, and Prolocor have developed advanced blood tests for CVDs that would enable more precise diagnosis of CVD in a timely manner.
The development of computational modelling and related techniques and the use of organoids and organ-on-a-chip (OoC) technology could also contribute to precision diagnosis and personalised treatment. Computational modelling mimics the electrical activity of the heart and interprets cardiac disease if ongoing, thus providing better insight into disease mechanisms. Also, incorporating patient-specific data into these models contributes to the prediction of patient response to different treatments, thus enabling more personalised and efficient treatment.
AI-based med-tech devices revolutionising CVD management
The use of AI and devices in tracking, managing, and treating cardiovascular diseases (CVDs) is gaining attention. For example, US companies like Edwards Lifesciences, Abbott, and Dublin-based Medtronic are developing wearable technology for the structural heart and electrophysiology markets. Switzerland-based SmartCardia and UK-based Ultromics are integrating AI into monitoring technologies to improve real-time continuous monitoring, identify at-risk patients, and reduce mortality and hospitalisation costs.
The rise in wearable technology is focusing on multi-lead and multiparameter devices for inpatient and outpatient settings. VitalConnect offers wearables as incorporated expenses in diagnostic solutions, allowing patient-specific reimbursement. Movn Health offers virtual rehabilitation solutions, while VitalConnect’s VitalPatch RTM wearable biosensor technology captures high-quality ECG signals for improved treatment. AI technologies are also being explored for data monetisation.
Huge investments and increased collaborations are key to pushing the growth of this sector in the Middle East.
Increasing focus on AI-powered diagnostics and medtech solutions in the Middle East
There are increasing collaborations to expand the geographical presence to the Middle East. For example, med-tech company Medicalgorithmics partnered with the Canadian Cardiac Centre to provide a heart arrhythmia diagnostics system to the new cardiology unit in UAE.
The system is based on PocketECG devices, and an AI-based diagnostic platform called PCClient. This is Medicalgorithmics’ second regional partnership since September 2019 and is part of a push into Middle East markets GE Healthcare, which is a global technology and digital solution company, collaborated with UAE’s Health and Humanitarian organisations, the Dar Al Ber Society and the Emirates Resuscitation Council to start a first-of-its-kind fully functional mobile cardiac catheterisation lab in the Middle East to lessen the burden of CVDs and other NCDs on the UAE population.
The partnership highlights the significance of social responsibility and multi-sectoral collaboration required to meet the country’s urgent healthcare requirements. The Emirates Cardiac Society is working as a member of the European Society of Cardiology, and this association will help reduce the burden of CVDs in the UAE.
Tier I global pharma companies are also investing to expand into the CVDs space. In 2023, AstraZeneca acquired US-based biopharmaceutical company CinCor for $1.8 billion. This investment, along with its other CVD deals between 2018 and 2022 valued at around $40 billion, demonstrates the depth of AstraZeneca’s expansion into the CVDs space, thereby reflecting the emerging interest by global companies in CVDs.
Therapeutic innovations beyond small molecules
CVDs, including peripheral artery disease, myocardial infarction, venous thromboembolism, atherosclerosis, rheumatic heart disease, arrhythmia, cardiomyopathy, ischemic cardiac disease, and coronary artery disease (CAD) are the leading cause of death worldwide, causing 17.9 million deaths in 2019. In the Middle East, coronary heart disease (CHD) is the main cause of morbidity, mortality, and disability. There is a growing need for new therapies and drug targets to reduce mortality rates, highlighting the potential for innovation and growth.
As per the latest Global Burden of Disease (GBD) 2019 study identified risk factors for coronary heart disease (CHD) death, including metabolic, behavioural, and environmental factors. The study found a downward trend in the burden of high systolic blood pressure and high LDL, while the burden of high fasting plasma glucose and high BMI increased between 1990 and 2019. These factors contribute to the highest attributable burden of age-standardised death rate for coronary heart disease (CHD ASDR).
The global therapeutic landscape for CVDs is continuously evolving due to the lack of effectiveness of small molecules, which are commonly used to treat CVDs. The therapeutic landscape is instead shifting towards more targeted therapies, such as gene therapies, antibodies such as monoclonal and multispecific antibodies, regenerative medicines, and DNA/RNA therapies. As certain diseases (like hypertrophic cardiomyopathy [HCM]) are caused by mutations in the MYH6 gene or aberrant proteins (such as the fibroblast activation protein [FAP] in cardiac fibrosis), these biomarkers (FAP, MYH6) can be explored as novel targets for CVD therapies.
Regenerative medicine products, such as Induced pluripotent stem cells (iPSC)-derived cardiomyocytes, tissue engineering, and advanced treatments (e.g., bone marrow mononuclear cells and adipose tissue-derived stem cells), are being developed. These products are divided into three categories: biomaterial-based techniques, pharmaceutical treatments, and cell implantation. Their applications include acute myocardial infarction, stroke, and ischemic heart failure management.
Further integration of AI, ML, and multi-omics would enable the accelerated development of therapeutics for CVDs. These advanced therapies could bring promising CVD treatments to the global market, potentially changing the conventional standard of care in the CVD space. The industry is aiming to balance traditional modalities with newer, more advanced approaches.
The way forward
Innovations across therapeutic modalities, precision diagnosis, and AI/ML-based med-tech devices are transforming the treatment and management of CVDs. These advancements offer opportunities for the Middle East region which has a high prevalence of CVDs driven by obesity, smoking and diabetes. Additionally, the region’s growing healthcare infrastructure offers opportunities for integrating advanced technologies and therapies. Middle East’s private sector can collaborate with global companies that are developing novel therapeutics and AI-powered solutions.
The collaborative environment, increased funding, and growing awareness of healthy lifestyles will benefit the Middle East region and help in better understanding, management and treatment of CVDs.
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