10 Exciting Health Stories From 2021 That Were Overshadowed in Another Pandemic Year
This past year's health stories weren't all about the pandemic. Here, we take a look at the most exciting medical advancements from 2021. Photo: Science Photo Library/Getty Images
It might seem like 2021 was all doom and gloom and grim tidings in the realm of health and medicine. But there was also much to be glad about and grateful for, beginning with the breakthrough mRNA vaccines for COVID-19.
On all fronts, from the labs to the bedsides, researchers and health care practitioners met the brutal challenge of COVID-19 with persistence and dedication.
Meanwhile, scientists who work in the fields of health and medicine achieved major breakthroughs in preventing, diagnosing and treating disease and prolonging healthful life.
1. Good News About COVID-19 … Yes, Really
While the arrival of the Omicron variant ensured that the year would end on a downer, disrupting holiday plans and festivities, it wasn’t déjà vu all over again. Boosters of the mRna vaccines, which are plentiful in Canada, have been shown to offer substantial protection against severe disease and death from Omicron. All in all, there was much good news about the progress made in dealing with the pandemic in 2021.
Vaccinations for all Canadian adults started ramping up early in the year and are now available for Canadians age five and over, including boosters for people age 18 and over in most provinces. As of this writing,77 per cent of eligible Canadians are double vaccinated.
Meanwhile, the federal government has signed a deal to buy up to 1.5 million courses of antiviral treatments developed late this year by Pfizer and Merck. In November, Pfizer announced that its antiviral treatment reduced the risk of hospitalization or death from COVID-19 by 89 per cent.
And despite lockdowns, isolation, job losses and business closings, the Journal of the Royal Society of Medicine reported in September that suicides in Canada unexpectedly fell 32 per cent in the first year of the pandemic compared with the year before. It’s the lowest suicide mortality rate in Canada in more than a decade, notes the Journal.
There’s also good news to come from the breakthrough scientific progress achieved with the messenger RNA COVID-19 vaccines developed by Pfizer-BionTech and Moderna. The vaccines’ mRNA technology has become a promising platform for combatting other diseases including malaria and for cancer immunotherapy. The Molecular Cancer journal reports that “mRNA is a powerful and versatile cancer vaccine platform. Its successful development towards clinical translation will remarkably strengthen our ability to combat cancers.”
As well, an experimental HIV vaccine based on mRNA already shows promise in mice and primates, according to scientists. Their results show that this novel vaccine was safe and prompted antibody and cellular immune responses against an HIV-like virus, the journal Nature Medicine reported this month.
2. New Drug Attacks Amyloid Clumps of Alzheimer’s
The first new medication for Alzheimer’s in 20 years was approved in June by the U.S. Food and Drug Administration. It has not been approved yet in Canada, but is under review by Health Canada. Aducanumab, sold by Biogen under the brand-name Aduhelm, is a monoclonal antibody that targets clumps of amyloid beta found in the brains of people with Alzheimer’s to reduce its buildup.
U.S. regulators say it’s the only drug that can likely treat the underlying disease, rather than just manage its symptoms. It’s recommended that Adulhelm should only be used by people with mild cognitive impairment or in the early stages of Alzheimer’s disease.
But Newsweek reported in November that “doctors have largely been hesitant because they aren’t confident yet that reducing amyloid in the brain will translate into improvement in scores on cognitive tests.”
According to the Canadian Medical Association Journal, “The approval of aducanumab by the U.S. Food and Drug Administration was controversial … Patients and clinicians are worried about aducanumab’s uncertain benefit, treatment burden (e.g., needing intravenous infusions of aducanumab every four weeks), safety and cost.”
Recently, Biogen said that it expects to begin a large clinical trial next May to confirm the benefits of Adulhelm, pending clearance from U.S. regulators. The trial could answer questions that have kept many neurologists from prescribing Biogen’s drug.
3. New Approach Stabilizes Beta Cell Function in Early Diabetes
Results of a clinical trial published by Toronto endocrinologist Dr. Ravi Retnakaran in August showed that a short, intensive course of insulin early in the disease can improve beta cell function “by reversing the reversible element of the defect in the beta cells.”
Based on this breakthrough, the new model of treatment “is induction therapy followed by maintenance therapy,” explains Retnakaran, clinician-scientist at Mount Sinai Hospital and professor of medicine at the University of Toronto
“At the outset of diagnosis, we do an intervention to improve the reversible component and then follow it with a drug (like metformin) to stabilize the function of the beta cells.”
The effect has been shown to last for two years, says Retnakaran.
“We’re now in the era of trying to change the natural history in terms of progression and risk of complications and both of those are ultimately important for the patient,” he says.
He’s currently studying different ways to do the initial induction and how to extend the effect beyond two years.
Retnakaran says he’s “optimistic about where things are headed. My sense is that diabetes is being better controlled and that there’s increasing awareness of what you can do in terms of lifestyle and management.”
4. Prostate Cancer Rates Slashed by Half
The Canadian Cancer Statistics 2021 report released in November revealed that the prostate cancer death rate has declined by 50 per cent since its peak in 1995. Advancements in precision surgery, targeted radiation treatments and drug therapy have played a major role in helping to cut the prostate cancer death rate in half.
PARP inhibitors — pharmacological inhibitors for cancer treatment — block proteins called PARP that help repair damaged tumour DNA in people with BRCA1 and BRCA2 gene mutations. Though known for their success in women’s cancers, two PARP inhibitors have been demonstrated to delay the progression of prostate cancer in men with refractory cancer and DNA repair pathway mutations. “PARP inhibitors are paving the way of precision medicine in prostate cancer, followed by drugs targeting the PI3k AKT mTOR pathway,” concluded the Journal of Hematology & Oncology in March. “Prostate cancer is the first disease where overall survival has been improved using a PARP inhibitor.”
5. Psychedelic Drugs Effective Therapy for PTSD, Depression
Psychedelic drugs, including MDMA (a.k.a. Ecstasy, E or Molly), and psilocybin are proving valuable for treating psychological issues when used in a therapeutic setting. Nature reported in May that MDMA-assisted therapy induces rapid onset of treatment efficacy, even in those with severe PTSD, and in those with associated comorbidities, including dissociative PTSD, depression, history of alcohol and substance use disorders, and childhood trauma.
Not only does MDMA-assisted therapy work well in people with severe PTSD, but it may also provide improved patient safety. Compared with current first-line pharmacological and behavioural therapies, MDMA-assisted therapy has the potential to dramatically transform treatment for PTSD and should be quickly evaluated for clinical use, the study concluded. Co-authors of the randomized, double-blind, placebo-controlled Phase 3 study include Emma Hapke of the University of Toronto, Sukhpreet Klaire of the British Columbia Centre on Substance Use and Dr. Simon Amar, Montreal.
Also, a study reported in the New England Journal of Medicine in April showed that psilocybin reduces symptoms of major depression as effectively as a daily antidepressant. A trial comparing psilocybin with escitalopram (brand name Lexapro) in a selected group of patients showed that the change in scores for depression at six weeks did not differ significantly between the trial groups.
Toronto-based Cybin, an international biopharmaceutical company, is focussing on translating the research into treatment. The company’s trademark tag line: Psychedelics to Therapeutics.
6. New Gene Therapy for Sickle Cell Disease, Thalassemia
The most common genetic blood disorders include sickle cell disease and thalassemia, which, combined, affect more than 330,000 children born worldwide every year. A new experimental gene therapy gives patients the potential to make functional hemoglobin molecules — reducing the presence of sickled blood cells or ineffective red blood cells in thalassemia. For a long time, the only cure for these diseases has been a bone marrow transplant, but new gene-editing techniques now may offer a safe and effective alternative.
In research conducted at Boston Children’s Hospital, scientists used a virus to switch off the gene that triggers cells’ sickling, according to a January 2021 study. The patients subsequently produced healthy red blood cells — and nearly all were able to discontinue the blood transfusions often required. The study followed six patients for a median of 18 months and found that the treatment completely halted the disease’s more severe symptoms.
7. Advances in Telemedicine and Technology: “Remote Everything”
Out of necessity, COVID-19 opened the floodgates for virtual care as most patient visits were conducted online during the worst of the pandemic. Patients and their doctors have learned to appreciate the advantages in convenience, accessibility and safety. Video and phone appointments are becoming the norm when an office visit isn’t required for tests or examinations. This trend is being supported by government initiatives, including Ontario announcing in July an extension of temporary virtual care fee codes for physician phone and video visits until Sept. 30, 2022.
As well, technology, including Bluetooth-enabled pacemaker devices, is giving patients immediate feedback and transmitting health information directly to their physicians.
The MIT Technology Review has dubbed this phenomenon, along with distance learning, as “remote everything.”
It’s especially important in African countries, including Uganda, where telehealth efforts have extended care to millions during the pandemic. In a part of the world with a chronic lack of doctors, remote health care has been a life saver, suggests the Technology Review.
8. Liquid Biopsies: Single Blood Sample Detects Multiple Cancers
In April, StageZero Life Sciences Ltd., headquartered in Richmond Hill, Ont., announced an early cancer diagnostic program with its flagship product, Aristotle. Aristotle is a multi-cancer detecting test capable of screening 10 cancers from a single blood sample with high sensitivity and specificity.
The company has carried out early validation studies in 788 patients across 10 cancer types and a total of 2,064 patients without cancer to great success.
StageZero intends to have two panels available for testing. The Aristotle Female panel has the capability of testing ovarian, breast, cervical, endometrial, colorectal, bladder, stomach, liver, and nasopharyngeal cancers, while the Aristotle Male panel can test for prostate, colorectal, bladder, stomach, liver, and nasopharyngeal cancers.
The Canadian biotech research company, which has a U.S. operation in Virginia, has partnered with U.S.-based Health Clinics and Care Oncology to launch the testing kits, priced at US$1,500. They’ll be available initially to Care Oncology’s current U.S. patients along with their immediate family members.
In June, another company focussed on early cancer detection, U.S.-based GRAIL, began marketing the first-ever prescription test intended to detect more than 50 types of cancer — most of which have no recommended screening test — with a single blood sample.
9. Diabetes Drug Shows Promise as Weight Loss Medication
Semaglutide (SGT), sold as Rybelsus tablets in Canada, were approved for diabetes management in 2020, but recent trials have shown that SGT may also be effective for weight loss in non-diabetic patients.
The journal of the College of Family Physicians of Canada reported in November that non-diabetic trial participants were given 2.4 mg of SGT weekly for 20 weeks and then randomized to either continued SGT or a placebo. After 48 weeks, the continued SGT group lost eight per cent of body weight compared with a seven per cent weight gain in the placebo group. The 2.4 mg dose of SGT is not yet available in Canada. Meanwhile, a U.S. trial, reported in March in the New England Journal of Medicine, found that that among adults who were overweight or obese (without diabetes), once-weekly injected semaglutide plus lifestyle intervention was associated with substantial, sustained, clinically relevant mean weight loss of 14.9 per cent, with 86 per cent of participants attaining at least five per cent weight loss.
10. Progress in Longevity, Regenerative Medicine Research and Technology
Scientists from McGill University have developed a biomaterial tough enough to repair the heart, muscles and vocal cords. This breakthrough, which combines chemistry, physics, biology and engineering, represents a major advance in regenerative medicine. The innovation also opens new avenues for other applications, like drug delivery, tissue engineering and the creation of model tissues for drug screening, scientists say. The team is even looking to use the hydrogel technology to create artificial lungs to test COVID-19 drugs.
As well, there’s been a significant growth in 3D bioprinting technology combined with stem cell technology, leading to advances in the field of tissue engineering and regenerative medicine. Scientists are working toward using this technology to build an entire living heart for transplant to solve the current bottlenecks of donor shortages and immune rejection.
Also, in a breakthrough for osteoarthritis prevention and treatment, scientists at the University of Southern California have used a stem cell-based bio-implant to repair cartilage and delay joint degeneration in a large animal model. Scientists believe that this bio-implant, which contains embryonic stem cells, has the potential to revolutionize the treatment of cartilage injuries, stopping arthritis before it starts. The research will now advance into humans with support from the California Institute of Regenerative Medicine.
Stem cell applications have been big news in 2021, including their role in preventing blindness. Experimental regenerative therapies for the eyes could help to save vision in people with glaucoma, macular degeneration and damaged corneas.
Finally, in low-tech longevity research in 2021, a large multi-centre clinical trial involving European men and women age 70 and older was initiated to test the benefit and cost effectiveness of three interventions: vitamin D (2,000 IU/day); omega-3 fatty acids (1,000 mg/day) and home exercise (30-minutem three times/week). Each of these has already shown considerable promise from prior studies and small clinical trials in the prevention of common age-related chronic diseases but definitive data has been missing, say researchers.