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Research by Professor Joost de Bruijn and team at QMUL from 2004 was critical to demonstrating the efficacy and commercial viability of a novel Instructive Bone Graft (IBG) product, AttraXTM. The technology, commercialised via the spin-out business Progentix Orthobiology BV (founded in 2007) was sufficiently mature by 2008 to attract series A investment of €1 million series A financing by BioGeneration Ventures. The development of AttraXTM has led to a trade sale totalling up to US$ 80 million to the global top 5 spine company NuVasive Inc. in 2009. In 2011 an exclusive distribution deal with a global top 3 dental company was signed for use of the technology in the field of dentistry and craniomaxillofacial surgery. After regulatory approval of AttraXTM in Europe (CE mark), the product was commercialised in 2011 and has been used successfully in more than eleven thousand patients (as of 2013Q3) with global reach (including EU, US, Australia, New Zealand and Brazil). Within 1 year of commercialisation, a 1.1% share of the estimated US$2 billion global spinal bone graft market has been achieved. This research has seen an economical benefit in terms of newly formed jobs from 2 FTE in 2008 to 25 FTE in 2013 at Progentix Orthobiology BV.
Seminal materials research at QMUL and its technological transfer via the QMUL spin-out ApaTech™, has led to the development of a range of cost-effective synthetic bone graft (SBG) products (ApaPore™, Actifuse™ and Inductigraft™), which safely and effectively stimulate rapid bone healing and are more reliable than previous autograft procedures. The successful use of the ApaTech™ range of products has delivered impact on health and welfare by reducing post-operative infection risks and improving recovery rates. To date, ApaTech™ products have been used to treat over 370,000 patients in over 30 countries. In 2010, ApaTech™ had 4% of the US SBG market, a $20 million annual turnover, employed 160 people in nine countries, and was sold to Baxter International for £220 million. By 2012, ApaTech™ products had attained a 10% share of the global SBG market (treating 125,000 patients per annum), estimated to be around $510 million. Other impacts include altering surgical clinical practice away from the use of autograft.
Our research has developed improved hip replacement fixation techniques, which have improved the biomechanical stability of implanted artificial joints. These techniques have been employed by orthopaedic surgeons, for example at Mid-Essex Hospitals Services Trust (MEHT), in primary and revision total hip replacement operations. As a result, the number of patients requiring revision hip surgery due to cup loosening has fallen by 50%. Additionally, these techniques have reduced the recovery time per operation by 3-5 days, which in addition to benefitting the patient have also resulted in an average saving per operation of £1,200.
Long-term fixation integrity is a critical issue in joint replacement surgery that affects both quality of life of patients and the economy. The unique comprehensive study of long-term acetabular cement fixation carried out at the University of Portsmouth has significantly informed orthopaedic surgeons and impacted on their surgical practice. In addition, research on a commercial hydrogel implant TRUFIT has informed clinical and commercial decisions on the use of the implant for load bearing applications, which has led to the withdrawal of the implant from the global market.
This case study describes the impact on practitioners and services through the development of new international standards based on research at the University of Aberdeen on Portland-limestone cements undertaken in 2004-8. The findings of this research have been adopted into revised international specifications for Portland cement mixtures in the European Union, Canada and the United States. The findings have also been incorporated into an industry standard software package (CEMDATA) for modelling thermodynamic properties of cement mixture, now established as part of the GEMS software suite freely available.
Research at the University of Sheffield has demonstrated that zoledronic acid is an effective and safe treatment for osteoporosis. It resulted in a new drug intervention (Aclasta/Reclast) which has been licensed in more than 100 countries and shows increased positive outcomes for patients.
As a result of the licensing of the drug, clinical guidelines have changed globally. For patients, the drug provides a preferred method of treatment, evidenced in surveys which show the majority of patients preferred an annual infusion of zoledronic acid to the alternative, which is the standard treatment of weekly oral alendronate.
Industry has invested in research and development of the drug. Novartis has funded studies into the efficacy and safety profile (up to 2012); in 2011, sales of Aclasta/Reclast were US$0.6 billion.
Research into the biocompatibility of glass-ionomer bone cements conducted at the School of Clinical Dentistry led directly to the start-up of a UK company to manufacture a new medical device, creating jobs in the supply chain and wealth creation via international sales. The new bone cement is safe and clinically effective, and has maintained or restored hearing to improve the quality of life of over 10,000 patients worldwide since 1st January 2008. In the course of supporting this commercial partner, Sheffield's staff also contributed to other non-academic tasks.
Building on work which has contributed, via NICE guidance, to £1 billion in annual savings to the NHS in its healthcare provision for osteoporotic fractures in older adults, research at the £14.4 million MRC Lifecourse Epidemiology Unit (LEU), University of Southampton, has inspired the world's first randomised controlled trial of vitamin D supplementation versus placebo in pregnancy. This work was designed to provide a definitive answer to the question of whether supplementing pregnant women with vitamin D leads to increased bone mineral accrual in the offspring. This work has also shaped national and international guidance on vitamin D supplementation both during pregnancy and in older age; Southampton's programme of osteoporosis research has attracted £10 million in research funding from health organisations and the EU.