Myriad Innovations At MedFIT, But Graphene Wound Dressing And Back Pain Relief Exoskeleton Get The Votes

Home to eight of France's major research organizations and ranked by Forbes magazine in 2013 as one of the top five most inventive cities in the world, Grenoble seemed a fitting location for the inaugural MedFIT partnering conference organized by the French economic development agency Eurasanté. The aim of the two-day meeting, held on June 28-29, was to build R&D collaborations between academia, start-ups and Big Medtech in order to accelerate entry into market for viable innovations, and the Start-Up Slam on the second day provided a platform to highlight some of these innovative projects that were on offer.

Eight technologies – all at a pre-commercial stage but some further down the development/clinical pathway than others – were pitched to a jury comprising medtech industry veterans, serial entrepreneurs, experienced product developers and investors. The technologies ran the gamut in terms of therapy areas but all appeared to be targeting potentially lucrative markets.

Defymed, for example, was one of the Start-Up Slam competitors targeting the billion-dollar diabetes market. More specifically, the Strasbourg-based company's MailPan bioartificial pancreas for type 1 diabetes would compete in a product sector dominated by medtech giants like Medtronic and Johnson & Johnson, among others.

Unlike current artificial pancreas systems that would typically comprise a closed, feedback loop between a mechanical insulin pump with a blood glucose monitor, MailPan is more a biological product, consisting of an implantable pouch for housing insulin-secreting cells. This pouch has non-biodegradable, biocompatible membranes with selective permeability; while they allow glucose and insulin to enter and leave the pouch, the membrane is impermeable to cells of the immune system like white blood cells and antibodies and cannot penetrate the pouch.

When the MailPan is first implanted in the patient, the pouch is implanted in the abdomen empty and without the cells to allow vascularization around the bag. Once vascularization is optimal, the cells are then implanted via one of two catheters which link the pouch to two ports implanted under the skin. The catheters act as channels for flushing out the cells from the pouch and injecting new ones in when they approach the end of their life span and need to be replaced. The MailPan acts like a biological pancreas with the cells autonomously regulating the level of glucose in the blood and releasing the required amount of insulin.

In December last year, Defymed forged a partnership with Boston, MA-based biotech company Semma Therapeutics, in which the latter will supply the French firm with stem-cell derived differentiated insulin-secreting cells. Richard Bouaoun, director of operations at Defymed, told Medtech Insight that Defymed is in advanced preclinical studies of MailPan and plans to enter clinical trials in Europe in 2018. The first has raised around €3.2m in equity funding to date and €6.5m in public grants. IT is looking to raise a further €10m to advance MailPan to CE mark and through clinical trials.

The winner of the Jury Prize for the most innovative start-up was Japet Medical Device, is also targeting a significant market, chronic low back pain, which affects 80% of the population in Western countries. The firm is further ahead than Defymed in its business plan and is planning to start clinical trials of its Atlas exoskeleton within the third quarter of this year.

Lille-based Japet was started by CTO Damien Bratic and CEO Antoine Noël, who worked together in medical robotics for five years before founding the firm. The Atlas exoskeleton, which looks like a corset and worn around the patient's waist, is designed for sufferers of debilitating chronic low back pain caused by excess pressure on the lumbar region. The device, said Noël, is the first of its kind to help bring immediate pain relief to these patients while they are undergoing physical therapy to retrain their muscles and bring back some functional strength.

Many chronic low back pain sufferers have to undergo physiotherapy, but the exercises are often very painful and difficult for the patient. In order to get the needed pain relief to do these exercises, patients would have to take pain medication.

The concept of the Atlas exoskeleton is to help patients through their physiotherapy by decompressing the spine – thus relieving the pain caused by the pressure – whilst they are performing the exercises. The exoskeleton has four rod-shaped micromotors to apply traction to the spine, as well as a set of embedded sensors to follow and adapt to the patient's movements and ensure they are performing their physical activities safely and comfortably.

Japet Medical Devices' Atlas exoskeleton

The Atlas exoskeleton applies traction to the spine to provide pain relief to chronic back pain sufferers so they can undergo physiotherapy more easily and comfortably.

Source: Japet Medical Devices

The Atlas therapy is not a cure for chronic low back pain, Noël acknowledged, but it helps to make the rehabilitative exercises easier to perform, which in turn should lead to better adherence of the physiotherapy and higher chances of resolving their back pain over the longer term.

Noël said Japet will be first targeting rehabilitation centers and physiotherapy clinics, which he estimates account for a market worth over €8m in Europe and the US combined. The bigger and more lucrative market would be for Atlas to be used for rehabilitation at home, where the patient could rent the system. This home care market is estimated to be worth around €25bn, according to the CEO.

If the clinical trials of Atlas go well, the company is expecting to CE mark the Class IIa system in the first quarter of 2018 and it hopes to enter the US market in 2020.

While it may not have won the vote of the official jury, the Grapheal wound care technology – incubated under the auspices of French tech transfer and start-up building company Linksium – got the thumbs-up from the audience and walked away with the Audience Prize for the most innovative medtech start-up.

Grapheal is a wound healing platform exploiting the features of graphene, a thin layer of pure carbon that not only has heat- and electro-conductive properties, but is also 200 times stronger than steel. Vincent Bouchiat, who invented Grapheal in the labs of CNRS (Centre national de la recherche scientifique) and is managing the project, explained to Medtech Insight that these specific properties of graphene enable the technology to be advanced from a passive wound dressing to a smart wound healing technology that not only has a therapeutic effect but also diagnostic capabilities.

Grapheal Wound Healing Technology

Prototypes of the three generations of the Grapheal graphene-based wound healing technology. On display in the Linksium stand at Eurasantés MedFIT 2017 event in Grenoble, France.

Photo: Tina Tan

The first-generation Grapheal bandage is a graphene-based scaffold that looks like a very thin, transparent plaster. The graphene layer of the scaffold will be in contact with the wound – "cells see it as a good support to build new tissue", said Bouchiat told Medtech Insight – to encourage cellular growth in advanced wounds and speed up healing. This first-gen bandage is currently undergoing clinical trials.

The second-generation Grapheal, which is not too far behind and is expected to be launched next year, will be an "active" bandage by taking advantage of graphene's electro-conductive properties. The bandage would be designed so that electrostimulation can be applied to the dressing and this electrical charge should help enhance the healing process.

The third-generation Grapheal, expected to be launched in 2019, will be a "smart" wireless bandage. While the graphene helps to heal, its electrical properties can be developed so that the bandage is designed to also monitor and detect possible infections as they're developing.

Bouchiat said he is now looking for a serial entrepreneur with the commercial expertise to spin out Grapheal as a start-up – hopefully in 2018 – that will focus on taking the product from bench to market.

Aside from diabetes, back pain and wound care, other product markets that the remaining contestants in MedFIT's Start-Up Slam were targeting include: noninvasive imaging of melanoma and carcinoma; dual-drug delivery; stress urinary incontinence; transcatheter mitral valve repair; and single cell analysis for cancer.

Below are details of these five other companies:

From the editors of Clinica.