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Treatments for hearing loss and tinnitus – what’s the future?

Action on Hearing Loss worked with an international group of clinicians to produce an article listing the companies currently developing treatments to protect or restore hearing, or silence tinnitus.

Hearing loss affects almost half a billion people in the world, and is also a risk factor for several other conditions, such as depression and dementia. In spite of this, there are still no treatments available to protect or restore hearing, or silence tinnitus.

In the laboratories of universities, hospitals, biotechnology and pharmaceutical companies all over the world, scientists are currently developing and testing these future treatments. Hopefully, one day they will complement or even replace hearing aids and cochlear implants, transforming the lives of millions that live with hearing loss and tinnitus.

What treatments for hearing loss and tinnitus should we expect in the future?

In our article, published in the scientific journal Otology & Neurotology, we identified 43 companies around the world that to date, have worked to develop more than 80 treatments for different types of hearing loss and tinnitus. The list is not exhaustive, so more treatments are likely to exist. Some of these treatments have already failed, but others keep on progressing.

Most of the treatments under development aim to prevent hearing loss caused by loud noise or medications that are toxic to the ear, such as aminoglycoside antibiotics or certain chemotherapy drugs, or to treat sudden hearing loss. These preventive treatments are the most advanced (in Phase II and III clinical trials), making them the most likely to reach people in the near future. Companies like the US-based Decibel Therapeutics or the French company Sensorion are already testing some of their preventive treatments in people. Preventive treatments also have the potential to prevent or slow age-related hearing loss, a type of hearing loss that is on the increase as the population gets older.

A smaller number of companies are developing treatments to restore hearing. Frequency Therapeutics, a US-based company, and Audion Therapeutics (REGAIN clinical trial) are already testing their regenerative treatments in people, with encouraging results so far. If successful, they will transform the lives of people who have lost their hearing. However, successfully regenerating lost hearing cells is one of the biggest challenges in treating hearing loss. As such, these approaches are not as advanced as the preventive approaches mentioned previously.

Most of these companies are developing drugs that can be taken orally or administered by injection through the tympanic membrane (eardrum), but a smaller number are developing gene and cell therapies. Gene therapies transfer healthy copies of genes to the ear to correct genetic alterations that cause hearing loss. Cell therapies replace defective cells with new, healthy ones. Cell therapies are still at a very early stage and are not currently being tested in people.

Companies are also developing techniques to efficiently deliver these treatments to the inner ear. The inner ear is located in the temporal bone at the side of our heads. It is one of the hardest bones in our body, making the inner ear very difficult to access. Therefore, new ways of delivering the right dose of treatment to the inner ear are needed. Otomagnetics, a US-based company that received two Action on Hearing Loss grants, is currently developing a magnetic system to deliver therapies to the inner ear.

Why is it important to know which treatments are currently being developed?

The process of taking medicines from scientific laboratories to patients is long, and sometimes disheartening for people living with hearing loss and tinnitus on a daily basis. However, it is important for people and clinicians to be prepared for the treatments that will one day change how we manage hearing loss. Some of these treatments will fail along the way, as developing treatments is a very rigorous process, demanding a lot of proof that new treatments are both safe and effective before they are approved to be used in people. However, others will succeed and when they do, they will change the way people live with hearing loss.

Further information

The original article was published in Otology & Neurotology: Schilder, AGM et al (2019) Hearing Protection, Restoration, and Regeneration: An Overview of Emerging Therapeutics for Inner Ear and Central Hearing Disorders. Otology & Neurotology 4:2019

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