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Blog > June 2012 > Fighting adhesion ‘barriers’ in the US: FDA approval for spine applications looming?

Fighting adhesion ‘barriers’ in the US: FDA approval for spine applications looming?

Contributors: Karen Gierszewski and Kyle Verleyen

Although it got off to a bit of a rough start, more and more experts are claiming that adhesion barriers for spinal applications are going to be huge. Adhesions, which are fibrous scar tissue, involve an abnormal connection between the soft tissue and organs and are a common complication following abdominal, spinal, and pelvic surgery. Adhesions are generally painful for the patient and often require further surgical treatment—in fact, it was estimated that the surgical removal of abdominal adhesions alone costs approximately $2 billion annually in the US. As a result, it’s easy to see why there is significant interest in reducing the incidence of adhesions following surgery, and why many industry experts claim that this is a significant unmet need in the medical world.

So why the interest in the spine? Well, for one thing, spine procedures represent a multibillion dollar industry in the US due to the large number of people suffering from back pain. Spinal implants (including fusion and nonfusion devices) were used in more than 350,000 thoracolumbar spine procedures in 2011 in the US alone, and this doesn’t include the many other spine procedures that can lead to the formation of adhesions.

Despite the interest in this space though, adhesion barrier technology for spinal applications struggled a bit to gain traction in the US. Although GLIATECH was briefly able to receive FDA approval for its ADCON-L, this product was later recalled due to concerns over possible contamination of the material from its aluminized paper lid liner. As a result, there are currently no adhesion barriers approved for orthopedic applications in the US.

Nonetheless, the latest results from FzioMed on its Oxiplex gel are promising, with patients treated with the product showing significant reductions in leg and back pain and lowered rates of reoperation. These results will hopefully lead to FDA approval and create a gateway for other adhesion barrier companies into the lucrative US spine product market.

Now the question is just when the adoption of these products will truly take off.
Posted: 6/29/2012 2:34:10 PM | with 2 comments


Filed under: US, Orthopedics

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Comments
Kyle Verleyen
Our summary of the problems with ADCON-L were focused more so on the technical aspects of the product, but I completely agree that the regulatory issues that followed played a major role in the product failing to gain traction in the US. The adverse events were likely experienced because GLIATECH provided falsified data to the FDA to gain initial product approval, and then later pleaded guilty to submitting these inaccuracies—ultimately causing the FDA to put a hold on selling the products in the US (http://www.apnewsarchive.com/2002/Gliatech-Pleads-Guilty-to-Fed-Charges/id-109d6eab13b2501271f6ad83a12d59be) Interest in the product segment from manufacturers likely waned in the aftermath. The new data from Oxiplex should help in creating interest again in orthopedic applications of adhesion barrier gels, given the estimated cost of treating adhesions in these indications throughout the US. I would love to hear any additional details and insights you have on the market—you can feel free to contact me directly at kverleyen@mrg.net.
7/10/2012 3:32:36 PM

David Wiseman
Your comments about ADCON and Oxiplex are not entirely accurate. The main reason why ADCON is not on the market is that, despite the resolution of the particulate issue, Giatech was forced into bankruptcy as a result of FDA placing a regulatory hold on them. it is sold outside the USA. The companies that picked it up, essentially dropped the ball on getting it back on the market.

For Oxiplex it had already been judged to be non-approvable by an FDA panel in 2008. The new data may help.

The cost of abdominal adhesions is likely in excess of $5MM - the paper you quote is only quoting old data. we have doen some recent trending analysis which puts it eevn higher.

I would be happy to fill in the details for you.
7/8/2012 4:57:59 PM

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