A Vote of Confidence in Canada
… and an invitation to do more R&D

Dennis Jeanes
Special to the Canadian Orthopaedic Foundation

As part of satisfying a long-ago promise to encourage Canadian research, Angiotech has agreed to donate $20,000 annually for the next three years to the Canadian Orthopaedic Foundation for its Canadian Orthopaedic Research Legacy (CORL) programme.

"Angiotech is pleased to be donating funds to support the work of the CORL programme," says Dr. Rui Avelar, Angiotech’s chief medical officer, who understands perfectly the need for curiosity-driven research. "We expect to invest between 15 and 18 percent of our resources to research and development. Thus, if we can help direct these funds toward research groups in Canada, then research is advanced, Canadians get published, and Canada’s reputation for top-quality orthopaedic research grows."

"We couldn’t be more delighted that Angiotech has decided to invest in the future of Canadian orthopaedic research," says Dr. Paul Wright, Foundation Chair. "Angiotech recognizes CORL is much more than a funding source, it’s also a meeting place of ideas. And, as Cy Frank often reminds us, the CIHR has funds for start-up of new research groups and networks. Now with the Angiotech connection, there’s tremendous incentive to get involved in clinical research. There’s certainly no shortage of questions to answer and technologies to test."

With the highly successful commercialization of its TAXUS® technology (see "Success Story"), Vancouver-based Angiotech Pharmaceuticals has evolved into a publicly traded, multinational corporation that does R&D throughout the globe and has more than 1,500 employees in six countries.

Angiotech now has a number of products in various stages of development that will have direct applications in orthopaedics – such as a synergistic compound that boosts the potency of an intra-articular steroid so that only one-twentieth the normal dose delivers all the usual anti-inflammatory benefits with none of the usual side effects.

While that’s good news, the really big news is that Angiotech’s founders are keenly interested in creating a legacy of Canadian research excellence, including in orthopaedics. "Bill Hunter [President and Chief Executive Officer of Angiotech] and I were trained in Canada [Hunter at McGill and UBC; Avelar at the U of T], and we always said that when the company finally became profitable we wanted to give back to the community, encourage more research and create more work in Canada," notes Avelar. "I find it upsetting that Canadians often aren’t given credit for the work they do. We think the orthopaedic community in Canada is fantastic, and the research potential is incredible."

Success Story
As corporate histories go, Angiotech Pharmaceuticals’ start-up was a classic case of thinking outside the box, combined with perfect timing.

In the early 1990s, medical-device manufacturers were anxiously exploring engineering options to counter the unavoidable trauma inflicted on coronary arteries from balloon angioplasty and then-novel arterial stents. Trouble was, even with such high-tech stainless-steel arterial scaffolding, from a quarter to half of these procedures failed (often in as little as six months) because of rapid tissue growth that led to coronary restenosis.

Dr. Rui Avelar

At the time, clinician/scientist and Angiotech co-founder Dr. William Hunter was investigating various diseases involving excessive healing. "To solve problems created by excessive tissue growth, what Bill thought was, ‘Why not deploy pharmacology in an entirely different way to create new compositions and medical devices?’" recalls Dr. Rui Avelar. "For tissue to grow, new blood vessels are required. Why not try to discover a drug/device combination that would inhibit processes essential to forming those new blood vessels?" This quest led to the discovery that the drug paclitaxel could safely and effectively inhibit such processes in the body, and resulted in a number of pioneering inventions, including the paclitaxel stent. Before this time, paclitaxel had only been used as an experimental agent of last resort to treat patients with advanced ovarian cancer who had already failed treatment with at least one other chemotherapeutic.

In 1997, Angiotech entered into partnership with medical-device giant Boston Scientific Corporation to commercialize the TAXUS® paclitaxel coronary stent, which is currently implanted in more than a million patients annually. The TAXUS stent technology "is now on record as the most successfully commercialized medical product in the world — bigger than Viagra, bigger than Celebrex, bigger than Lipitor," says Avelar, with no small pride. "We did more than $2 billion in sales in the first year. Very few technologies ever do a billion."

"We think there is incredible potential for this fusion of drug and device, given all the biomaterials and devices that are put into the human body every year," says Avelar. "We found we could make a fairly compelling argument about almost every device or biomaterial for why you would add a drug." As a result, Angiotech’s scientific programme tackles four basic problems: too much healing tissue, not enough healing tissue, local infection, and tumours. Its product list now numbers in the thousands.