Key takeaways

  • Electroceuticals are devices that alter the electrical messages sent through nerves.
  • With a range of conditions potentially treatable using the technology, its targeted nature will no doubt appeal to patients.
  • Pharmaceutical and health providers will need to consider outside partnerships to compete in this new arena.

Is it possible to come back from the dead? According to a recent study, yes. Sort of.

In a vegetative state for 15 years, a man from France was coaxed into minimal alertness after electrical stimulation of the vagus nerve between his brain and abdomen¹.

A September 2017 medical paper² reported that the patient became conscious enough to respond to the outside world – turning his head when asked and expressing surprise when someone came close to his face. Scans showed activity between regions of the brain where previously there had been none.

Devices that affect electrical signals flowing along nerves could be the way of the future when it comes to personalised, targeted medicine. If such treatments could be miniaturised and fitted to nerve bundles within the body, they could replace traditional drug therapies.

The electroceutical
effect

Electroceuticals, or bioelectronics, refer to tiny electronic implants that alter the electrical impulses along nerves. In simple terms, these impulses affect the messaging that the brain sends to parts of the body to do certain things, e.g. the stomach to feel full or an organ to release a hormone.

The concept of using electronic signals to treat ailments is not a new one, with spinal cord stimulation (SCS)³, cochlear implants, pacemakers, deep brain and other neurostimulation4 all examples of therapies currently being used with success.

The hope with electroceuticals is that by miniaturising electrode devices and attaching them to strategic nerves the body can be fed alternate messaging in order to to heal itself or inhibit a vast range of chronic diseases and afflictions. These could range from allergies, migraines, asthma and obesity all the way up to hypertension, infertility and possibly even cancer5.

Electroceuticals are still in the very early stages of development and scientific opinion is divided on their efficacy but several pharmaceutical and technology companies are betting on its success.

Will pharmaceuticals
become electroceuticals?

So far, the majority of pharmaceutical companies are staying quiet on whether or not they think electroceuticals are the next big thing or a disruptive threat.

Some have chosen to invest in the work of individual scientists, or in tech companies that focus on related areas, such as Johnson & Johnson and Boehringer Ingelheim’s investment in startups focused on stimulation devices and miniaturisation6.

GlaxoSmithKline and Alphabet’s Verily Life Sciences have formed a joint venture, Galvani Bioelectronics7, to combine IP, invest in startups and research, and offer a US$1million prize to develop a miniaturized implantable device that will record, stimulate and block neural signals, with stability, for a period of 60 days8.

The newly formed company recognises that “bioelectronics requires the combined skills of world-leading biologists, engineers, clinicians and technologists.”9 Success will depend on alliances between a great range of industries and disciplines, many who have not had reason to work together before10.

Zapping pain
with personalised treatment

There are a number of reasons why health providers, tech companies and big pharma are interested in the potential use of electroceuticals.

Unlike biological therapies, such as pharmaceutical drugs, electroceuticals have the potential to provide targeted, personalised, medicine. Traditional drugs take a scattergun approach to care. They suffuse the body, often in places they aren’t wanted – solving one issue, but creating many more in the form of difficult to predict and potentially fatal side effects.

For patients, who are increasingly looking for personalised health solutions, one that targets only the problem they are aiming to solve would be undeniably attractive. Treatments could be further customised to a particular person’s needs, responsiveness and anatomy11.

The ability to ‘set and forget’ as the technology becomes smarter and more robust has obvious advantages over an inconvenient daily regimen of drugs that can be forgotten, dangerous in the wrong combination, or misprescribed.

In terms of pain management, electroceuticals, like spinal cord stimulation, also offer the ability to decrease or block pain in patients. For instance, they are already being trialled (with some success) in blocking the body’s release of a protein that triggers inflammation, alleviating the pain suffered by those with rheumatoid arthritis or Crohn’s disease12.

For the pharmaceutical industry, blamed for the present day opioid crisis13, the ability to expand business opportunities in pain management without the negative publicity and potential harm to patients, this must surely hold some allure.

Cure-all
or snake-oil?

Despite the positives, electroceuticals are far from a done deal. There are a number of challenges that the treatment faces.

For one, the nervous system hasn’t yet been mapped, nor is it particularly well understood. The extent of knowledge over which nerves control what parts of the body is far from complete8. Whether specific targeting of organs, chemicals and nerves within the body can be done with the accuracy required is not yet widely confirmed.

Like all technological ventures there is also the question of the security of such ‘treatments’. Where there are electronics and device connections there is the possibility of the technology being compromised.

What happens when someone gains access to the electrical impulses in your body and holds you to ransom? Sounds far-fetched? It’s not. Just this year the US Food and Drug Administration recalled nearly half a million pacemakers due to a vulnerability that could allow hackers to literally stop hearts beating14.

The ultimate medicine
…maybe

The technology, and the science, is still in its infancy. As a burgeoning industry, it is one that need more time and research to develop.

It could be as far as the mid to late 2020s before real progress is seen. Patient demand for personalised care seems to align nicely to the offer this treatment promises and, with nearly two billion people currently suffering from chronic diseases, the potential market is huge8.

People will only become more sophisticated and involved in the ownership of their health. With increasing interest in wellness from non-traditional players, it seems wise for those in the business of healing to keep an ear to the stethoscope on this one.

 

Contributor

Richard Royle

Richard Royle is a partner at PwC Australia and is the national and regional digital health lead.

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