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Regenerative medicine for hearing loss makes quiet progress

An analysis of the competitive landscape in regenerative therapies for hearing loss

While the late-stage programs for hearing loss are designed to protect cells in the inner ear, or help them recover from trauma, a growing number of early-stage therapies is aiming for a more dramatic outcome -- hearing restoration through regrowth of neurons and synapses that have died.

In 2017, only Novartis AG (NYSE:NVS; SIX:NOVN) had a therapy in the clinic designed to replace hair cells -- the neurons in the ear that detect sound. At the time, eight other companies had disclosed preclinical hearing regeneration programs (see “Ears Wide Open”).

The tally has since grown to six clinical and seven preclinical programs (see Table: “Hearing Regeneration Pipeline”).

Readouts from three of these therapies could become available this year.

Figure: Regenerating the cochlea

The organ of Corti in the cochlea contains four rows of hair cells that form synapses with innervating nerve fibers, shown in transverse section in the figure below. Degeneration of the hair cells, synapses and nerves can all contribute to permanent hearing loss. Companies are taking a variety of approaches to regenerate these cochlear components, including two forms of hair cell production from other cells present in the cochlea. Four companies are trying to transform cochlear support cells into hair cells through direct differentiation

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