Biggest medical achievements of 2023

In 2023, the affordable and quality artificial intelligence (AI) models, most famously ChatGPT, changed the world. They have impacted many fields, and medicine is no different. The specificity of this field requires surgical precision and does not tolerate mistakes. Medical researchers are using the strengths of AI technologies – the ability to work with large data sets and deep analytical capabilities – to uncover connections that even the largest teams of researchers are unable to identify.

In 2023, a multinational team published a study in one of the most prestigious journals, Nature, proving the feasibility of using AI to detect the risk of pancreatic cancer in patients up to 3 years before the disease develops. The importance of this discovery is that pancreatic cancer has one of the worst treatment prognoses at inoperable stages, and in most cases is diagnosed in an already advanced state.

The AI model analysed the medical records of more than 6,2 million patients over 41 years, among whom 24,000 were subsequently diagnosed with pancreatic cancer. By comparing specific sequences of events leading up to the diagnosis, the model was able to identify risk factors and detect them in new patients. Applying the technology to a database of US veterans has been able to predict cancer in more than 4,000 people.

In 2023, the US Food and Drug Administration (FDA) approved the use of a new method of breast ultrasound imaging, SoftVue. This technology uses ultrasound waves to create a 360° 3D image of the organ.

The method was developed specifically for cancer screening in women with high breast tissue density. According to the NCI, they make up 40% of the population and are 4-6 times more susceptible to cancer. Standard mammography is less effective for these patients because it can miss a cancerous mass or mistake a benign neoplasm for a malignant one. According to studies, conventional mammograms miss up to 40-60% of cancers in women with high breast density.

SoftVue helps eliminate this problem. The technology improves screening accuracy by 20% and is less likely to lead to “false positives” – cases where women are diagnosed with breast cancer when it is not present.

A new method of foetal genetic diagnosis (NIPD & NIPT) can assess the risk of more than 100 genetic diseases, determine the sex and blood type of the unborn child, and confirm paternity non-invasively. Standard protocols use amniotic fluid analysis for this purpose, which is normally tolerated by most women, but can lead to miscarriage in high-risk pregnancies.

The new technology can “capture” small samples of foetal DNA from the mother’s blood for analysis. This is a completely safe and reliable diagnostic method.

In addition, non-invasive prenatal diagnostics can be used to perform a paternity test in the first trimester of pregnancy, starting at week 7. The duration of the test in most laboratories takes an average of a week.

An important point is that prenatal diagnosis by blood test can only be carried out in the case of a single pregnancy. If there are twins, the mother’s bloodstream will contain cells from both children, which cannot be separated from each other in the laboratory.

Alzheimer’s disease is one of the most common neurodegenerative diseases characterised by consistent memory loss, impaired thinking, personality changes and emotional disturbances. This disease cannot be cured and all therapeutic approaches are aimed at slowing progression.

In the summer of 2023, the FDA approved a new drug, Lekembi (lecanemab). This is the first drug that treats the cause of Alzheimer’s disease – the accumulation of amyloid plaques in brain tissue. They provoke inflammatory processes and disrupt the connections between neurons, which leads to memory impairment and other symptoms of the disease.

Lekembi belongs to a group of drugs called monoclonal antibodies. It is a type of targeted therapy, in other words, drugs that have a targeted effect on selected disease-causing cells. The drug destroys existing plaques; however, it cannot prevent the formation of new ones, so a complete cure cannot yet be achieved.

No. 1 medical breakthrough according to the Science journal

Obesity is a complex metabolic problem that carries an increased risk of a large number of diseases, including cancer. According to WHO, it affects more than 39% of the world’s population. The standard treatment plan for obesity – physical activity and diet – requires a lot of effort and motivation on the part of the patient, and not everyone manages to stick to a healthy lifestyle. In 2023, doctors started using a new group of drugs that can help with this problem – GLP-1 agonists.

These are synthetic drugs similar in structure to the human hormone glucagon-like peptide-1, which is produced in the gut. It causes a feeling of satiation, as well as slows digestion and lowers blood sugar levels. These drugs were originally developed to treat type 1 diabetes, but this year doctors revealed that they have many benefits for regular obese patients as well.

Stent retrievers have been revolutionising the treatment of stroke patients for the last few years. The market for these devices has doubled in 2023. These are special devices that look like a catheter made of a thin mesh material that is placed along the blood vessels to the area where the neurovascular disease has occurred and removes blood clots.

The use of stent retrievers in the first 2-7 hours after a stroke dramatically reduces the risk of stroke recurrence and reduces long-term damage to brain tissue. The rehabilitation period for these patients becomes shorter and easier.

Modern clinics are combining stent retrievers with drug therapy, neuroprotective agents and even stem cell treatment to further accelerate the neurorehabilitation process.

Neurofeedback systems can mimic the natural nerve function of amputation patients to help them adapt to the use of prosthetic limbs.

These devices “collect” information about the pressure on the robotic foot while walking and transmit it to electrodes specially implanted in the peripheral nerves on the residual limb. The information from there goes to the brain, just as it would during the natural process of walking in a healthy person. The brain reads it and reacts accordingly, resulting in more precise coordination of whole-body movements – and best of all, it’s all completely subconscious.

Patients with prosthetic legs who use neurofeedback devices can walk and climb stairs faster and with greater confidence, and their movement accuracy increases by 20%. Patients with prosthetic arms have improved fine motor skills: for example, they can pick up small and fragile objects more easily.

During the 2023 Annual Conference of the Association for Advanced Technology and Diabetes (AATD), the medical community shared two promising methods for non-contact glucose measurement in diabetic patients. These were breath analysis and glucose measurement using light (Raman spectroscopy). These innovations eliminate the need for continuous blood draws. Patients get real-time results, providing better control over their condition.

Such technologies have been available in the scientific world for a long time, but they can only be performed in large laboratories. The innovation comes in the development of small devices that patients can carry around with them, and which will still provide as accurate and reliable results as previously available methods of measuring glucose levels.

Both technologies are already undergoing practical trials, and the researchers boast optimistic preliminary results.

The possibility of “removing” the disease from patients’ DNA has long been hotly debated in the medical community, but the complexity and sensitivity of such a treatment have long stood in the way of its introduction into everyday practice. And now in 2023, the first shift in the future of gene therapy has occurred – the FDA has approved the first-ever gene modification drug to treat children with Duchenne myodystrophy, a dangerous disease that leads to degeneration of muscle tissue and premature death due to impaired production of a vital protein. Gene therapy finds the stretch of DNA responsible for the formation of this protein and “fixes” it.

The drug uses CRISPR/Cas9 technology to edit genes. This technique is famous for the fact that its researchers won the Nobel Prize in Chemistry in 2020.

Who can benefit from this?

 

People whose families inherit the Duchenne myodystrophy gene.

Just like the previous technique, gene therapy for sickle cell anaemia uses CRISPR/Cas9 technology to edit genes. The gene therapy, called CASGEVY, corrects defective haemoglobin genes in the patient’s bone marrow stem cells so that they can produce complete haemoglobin. The patient’s stem cells are taken from their bone marrow, edited in the lab, and then injected back into the patient. A single treatment has the potential to completely cure the disease.

Previously, the only way to completely cure sickle cell anaemia was a bone marrow transplant. However, a big problem with this approach is finding suitable bone marrow donors. Gene therapy has the potential to remove this obstacle.

Who can benefit from this?

 

People whose families inherit the gene for sickle cell anaemia.