Memorandum

Metronom Health, stealth implantable CGM company, raises $4.8 million; CGM competitive landscape overview – July 18, 2014

Executive Highlights

  • According to a July 9 SEC Filing, Metronom Health has raised $4.8 million from five undisclosed investors. Per a September 2013 US patent filing, the company appears to be working on an implantable CGM.
  • By our count there are at least 27 companies working on CGM devices, both early and late-stage.

According to a July 9 SEC Filing, Metronom Health has raised $4.8 million from five undisclosed investors in an all equity transaction. There is scarcely anything about this company online, but per a September 2013 US patent filing, the company appears to be working on an implantable CGM. Metronom Health’s approach revolves around “a stabilized oxygen transport matrix that includes a reversible oxygen binding protein...The stabilized matrix collects oxygen, stabilizes oxygen dynamics, and rapidly transports oxygen within the matrix.” We could not find any trials posted on ClincalTrials.gov, so we assume this is still in early stages of development.

Laguna Hills, CA-based Metronom health was incorporated back in 2009. An October 2012 article notes that company Founder and CSO Troy Bremer was a former aerospace engineer that left his career to “pursue a PhD under the guidance of the world’s leading expert in glucose biosensing at UCSD” (we assume Dr. David Gough, who led the first CGM meeting we attended in San Diego back in 2002). Based on the SEC filing, the management team includes Olav Bergheim, Troy Bremer, Hugh Neuharth, Charles Chon, and Michel Lussier. Metronom Health is a portfolio company of Fjord Ventures, a VC firm with one other diabetes portfolio company: Orchest (no information online).

The list of companies working on CGM grows by the day – below, we include a non-exhaustive summary of the 27 companies we are aware of. Many are also discussed in our full report on the 2014 Tissue Response to Implanted Active Medical Devices Meeting. That small conference made it clear that beyond current percutaneous CGMs (Abbott, Dexcom, Medtronic), there are other novel approaches that may be clinically and commercially viable in the future. In the past few years, there have been significant advances in the field of biomaterials that are likely to impact the design, size, form factor, and usability of future diabetes technology. Long-term implanted glucose sensors were explored almost twenty years ago, most notably by MiniMed and Dexcom, but abandoned because of the size of the devices, poor reliability, and long development cycle times.

Summary of Early- and Late-Stage CGM Technologies in Development

  • The table below represents our best knowledge of the CGM competitive landscape, both early- and late-stage. We acknowledge that the table is likely not completely comprehensive of all companies working on CGM. We’ve done our best to include the most up-to-date status of each technology, but have been unable to reach all companies in the table.

Company

Product/Approach

Status

Recent Coverage/News

Abbott

FreeStyle Libre (previously known as “Flash Glucose Monitoring”) – this is not CGM in the traditional sense, but still uses a subcutaneous sensor to provide continuous data

EU Launch in 2H14; EASD 2014 Symposium

Abbott 2Q14

Dexcom

-G4 Platinum
-Animas Vibe integration
-Share (remote monitoring)
-G4AP algorithm
-Tandem t:slim integration
-Gen 5 (smartphone)
-Gen 6 (new sensor)

-Available worldwide
-Under FDA review
-Under FDA review
-Clinical study complete
-Filing expected in 2Q14
- ~2015 launch
- ~2017 launch

Dexcom 1Q14

ADA 2014 (late-breaking poster #75)

Medtronic

-Enlite
-Enhanced Enlite (Enlite 2)
-MiniMed Duo
-Sentrino (in-hospital)
-Enlite 3
-Connected Care
-Orthogonally redundant

-Available worldwide
-Launched in EU
-Launched in EU
-Launched in EU
-Starting US study
-Timing unclear
-Data shared at ATTD

Medtronic 2014 Analyst Day

San Meditech

TD Integrated

-Available in China

ADA 2014 Exhibit Hall

Edwards/Dexcom

GlucoClear 2 (critical care)

CE Marked; EU evaluations ongoing

Edwards 1Q14

Roche

Needle-type sensor

Comparison study vs. Dexcom G4 Platinum completed

ADA 2014

BD

-Optical-based sensor
-Combined CGM/infusion set

Data expected in early 2015

BD F2Q14

Insulet/unnamed partner

Combined CGM/OmniPod

Insertion study completed

Insulet 1Q14

Echo Therapeutics

Symphony (critical care)

Undertaking Gen 2 study to gather additional clinical data

Echo Therapeutics 1Q14

Senseonics

Implantable CGM

90-day study completed

ADA 2014

GlySens

Implantable CGM

Small six-month clinical study completed (n=6)

Tissue Response to Implanted Active Medical Devices Meeting

Glucovation

SugarSenz

Completed testing of alpha prototypes; seeking funding; ongoing patent suit with Dexcom

Glucovation fundraising page shares detail on company and approach

Google/Novartis

Smart contact lens

Prototype for testing by Spring 2015; commercial launch within five years

Novartis/Google announcement

Novartis 2Q14

Apple

Smartwatch with glucose monitoring? (speculated)

Slated to launch in fall 2014

Summary of recent speculation

Microsoft

Smartwatch with glucose monitoring? (speculated)

Slated to launch in fall 2014

Profusa

Tissue-integrating implantable CGM

Data expected in 2015

Tissue Response to Implanted Active Medical Devices Meeting

Biorasis

Sensor coated with microspheres that release dexamethasone (inhibits the foreign body response) 

 

Startup acquired intellectual property from University of Connecticut

Tissue Response to Implanted Active Medical Devices Meeting

Cal Tech (Supported in part by Sanofi)

 

Miniaturized fully implanted CGM

In pre-clinical studies

Tissue Response to Implanted Active Medical Devices Meeting

EyeSense

Percutaneous optical fiber CGM

 

Ten-patient study reported at ADA 2013

ADA 2013

Metronom Health

Implantable CGM

???

Enclosed

Sano Intelligence
(Backed by Rock Health)

Wearable sensor to capture and transmit blood chemistry data

 

???

CrunchBase Page

Pacific Diabetes Technologies

Single-site CGM/insulin infusion

Preclinical study presented at ADA 2014

ADA 2014 ePoster (69-LB)

iSense (formerly owned by Bayer)

Seven-day subcutaneous CGM

Last mentioned in Bayer symposium at ATTD 2011

 

ATTD 2011

GlySure

Bedside CGM for ICU

Nearing CE Mark as of January 2014

Interview with CEO

OptiScan

Bedside CGM for ICU

CE Marked in 2011

CE Mark announcement

Maquet

Microdialysis (critical care)

Study published in DT&T 2013

Schierenbeck et al.

A. Menarini Diagnostics

Microdialysis (in-hospital)

???

 

 

Close Concerns Questions

Q: Will implantable CGM come to market?

Q: What length of implantation will be necessary to encourage patients to use implanted CGM?

Q: How will the regulatory requirements for implantable CGM differ from those used for subcutaneous CGM? What study length will be required?

 

-- by Adam Brown and Kelly Close