Pfizer is betting big on the Internet of Things, or IoT, in medicine–that is, the connectivity of physical objects like medical devices to collect and exchange data–to boost Parkinson’s R&D and ultimately, to better inform care for patients.
To make this nebulous idea a reality, the pharmaceutical company is partnering with computer titan IBM IBM -0.10% to develop a system of sensors, mobile devices and machines that could deliver real-time, around-the-clock disease symptom monitoring of Parkinson’s patients to clinicians and researchers.
Peter Bergethon, vice president and head of quantitative medicine at Pfizer, explained that Pfizer’s interest in an IoT is twofold: research and commercial. The company will first pilot the system in a clinical trial setting, and eventually, Pfizer wants to pursue a regulatory path for its IoT to market it to healthcare providers.
“We need to understand not just why we’re making someone symptomatically better, but we also need to identify earlier on who needs the drug and if we’ll be able to make a difference in the disease progression,” Bergethon said in an interview.
Pfizer is aiming to begin a clinical trial using the IoT in 2018 and enroll up to 200 research participants, both control subjects and those with Parkinson’s disease who are already taking existing therapies to manage their symptoms.
Bergethon explained that Pfizer chose to pilot this ambitious project in Parkinson’s patients because the disease requires frequent adjustment to medication depending on how the disease is progressing and how the patient is responding. The fact that the technology needed to measure motion in movement disorders already exists and is quite advanced was also a major factor.
Pfizer and IBM haven’t built its IoT prototype yet, and Bergethon told me he couldn’t yet divulge details on what it might physically look like. But he explained that the remote monitoring solution would be easy to use and noninvasive so that patients could use it at home in their daily lives without the help of a clinician or other aide. For example, patients might place a wearable sensor on their elbow or wrist. That sensor would be connected to other sensors, medical devices and applications through online computer networks.
That system will measure a range of health indicators, including motor function, dyskinesia, cognition, sleep and daily activities such as grooming, dressing and eating. By monitoring this data, clinicians ideally would be able to better understand the effect of a patient’s medication as the disease progresses, enabling them to adjust the patient’s treatment regimen as needed. In a research setting, data generated through the system could provide drug developers with real-world evidence needed to accelerate new and better therapies.
Currently, clinicians rely on getting these types of observations and changes in health from patient anecdotes during doctors’ visits. Needless to say, that information can be subjective and unreliable.
Neither company is commenting on how much each is investing in the project. But on the research side, an IoT could have cost savings for Pfizer–and other pharma companies that pursue such technology. Clinical trials are enormously expensive, and if drug developers could find out sooner if a drug is or isn’t working, that could save money no matter the outcome of the trial.
Pfizer already has plans to test its Parkinson’s compound PF-06649751, currently in Phase 1, alongside the IoT in a Phase 3 clinical trial in 2019.
“The system will be able to tell you the pharmacodynamics of how well the drug is working and when it’s working. That’s an important thing to be able to tell the patients as well as the doctors, regulators and insurance companies,” Bergethon said.
Currently, there are many approved drugs on the market to treat the symptoms of Parkinson’s, the most common and effective of which is Carbidopa/levodopa, developed in the late 1960s and marketed under the brand name Sinemet by Merck. But no existing Parkinson’s therapies actually reverse the effects of the debilitating disease. In addition, prolonged use of levodopa can cause dyskinesia, or spontaneous, involuntary movements, as well as fluctuations in treatment when the medication will suddenly and unpredictably start or stop working. Despite advances in medicine that have improved quality of life for Parkinson’s patients, the mortality rate remains largely unchanged.
While Pfizer and IBM’s IoT is still a few years away, the pharma giant is already looking ahead at how the system could be used to monitor other movement disorders and degenerative diseases in a clinical trial or healthcare setting.
