This is an interesting and topical review of the emerging biotechnology and pharmaceutical solutions for hearing loss and related conditions such as tinnitus. This paper suggests we are on the cusp of a very large step-change in the way we treat hearing disorders. It aims to give an up-to-date and comprehensive answer to the often-asked question by patients, particularly those with tinnitus; ‘is there a drug being developed which will cure my condition?’ It appears from the long list of novel drugs in the various stages of development that there might well be an injectable pharmacological agent available in the not too distant future; 72% of the 43 companies reported on here are developing drug therapies.
This review, which uses literature searches including both scientific and ‘grey’ literature, splits the 62 identified products into seven main therapeutic approaches: otoprotection, regeneration, reduction in tinnitus perception, central hearing disorders, balance, gene correction and drug delivery systems.
Although some products have gone as far as phase three clinical trials (and no further), none as yet are available for clinical application. Otoprotection product development trials are by far in the majority (35 of 76 active programmes) and aim to preserve the auditory system from drug/age/noise-related damage. The trials looking at novel therapies for tinnitus have had the biggest setbacks, which the authors feel may be due to the underlying difficulties defining objective outcome measures. The real strength of this paper is that it is drawing our attention as clinicians to what is coming in the pipeline from industry/basic science research and development, so that we can begin to plan in a coordinated and timely manner how we can safely and efficiently implement these novel therapies. We can learn from the analogous situation in opthalmology with new biologic agents for treatment of macular degeneration, which had problems with subclinical outcomes and economic inefficiency. They stress in this report that the process of engagement with stakeholders - in particular patients, health economists and commissioners - needs to begin even at this early stage.