hances are you know someone who has type 2 diabetes, a condition that occurs when the body isn't able to make enough insulin to keep blood glucose levels in check. And while it can be managed with the right treatment and tools, for some living with type 2 diabetes, the condition can lead to blindness, stroke and even lower limb amputation. Diabetes was also the direct cause of an estimated 1.6 million deaths in 2016.
But Janssen, part of the Johnson & Johnson family of companies, is on a mission to help change that statistic.
Leading the charge is Chiara Magnone, Ph.D., Vice President, Metabolic Complications, Janssen Research & Development, and Director of a new Boston research center focused on preventing and treating potentially fatal diabetes-related diseases, such as chronic kidney disease (CKD) and nonalcoholic steatohepatitis (NASH).
We sat down with her as part of our New Year, New Vision series of interviews with healthcare movers and shakers to learn more about her passion for research and her goal of one day finding a real cure for what she calls “the disease of the century.”
What inspired your career in diabetes research?
I have always felt a calling to improve people’s lives through science. I began my career in the field of neuroscience, focusing specifically on multiple sclerosis (MS). This is an area of high medical need, since MS is a devastating disease that often affects young, otherwise healthy individuals.
But about a decade ago, I became very interested in type 2 diabetes. It seemed that it was rapidly becoming the disease of the century, if not the next millennium. I felt there had to be better ways to treat patients other than the traditional therapies of drugs, such as metformin or, in more advanced cases, insulin.
As I was immersing myself in the field, it became clear to me that the quality of life of many people with the disease was really terrible. What many of us don’t realize is that it’s not diabetes itself that kills you—it’s the related complications, such as CKD, NASH and cardiovascular disease. Yet although 160 million patients with type 2 diabetes worldwide will develop CKD, it’s been nearly two decades since a new treatment for diabetic kidney disease has been identified.
We don’t have any time to waste. Now that diabetes has become so prevalent, due to the rise in obesity, the disease population is rapidly becoming younger and younger. Children diagnosed with type 2 today will die early if we don’t step up and do something for them.
You were recently tapped to help oversee groundbreaking work being conducted at a new research center in Boston. What is your vision?
I’ve always been interested in precision medicine—that is, identifying the most effective approach for treating each individual patient based on their genetic, environmental and lifestyle factors.
I have often seen precision medicine treated as an appendix to drug discovery—something that you do at some point to improve a medicine’s development, rather than focusing on it from the start. But Janssen shares my commitment to precision medicine, and is leading the way to help advance highly differentiated therapies that have the potential to prevent and treat life-threatening complications associated with type 2 diabetes.
That’s why I’m so thrilled to be heading up Janssen's new CVM Boston Development Center. Our center just opened last August, so I’m focused on getting everything up and running. My task right now is to build up our scientific team. We currently have a staff of 18—including, one of the world’s leading experts in diabetic nephropathy (kidney damage) and now a Distinguished Scientist at Janssen Cardiovascular and Metabolic Discovery Research—and we’d like to bring on six to seven more. I’m proud to say we have a diverse team when it comes to background, age, gender and nationality; 10 different countries are represented at our site alone!
We’re also exploring the idea of a once-in-a-lifetime treatment for type 2 diabetes complications, just as some people undergo a once-in-a-lifetime CAR-T therapy for their cancer. If you could perform therapy early on, when the complications are still in their infancy, there's tremendous potential when it comes to improving quality of life.Share
We also believe in the power of open exchange with other top scientists, and this city also has access to some of the best medical minds around, including at MIT, Harvard, Joslin, Massachusetts General Hospital, Brigham and Women's Hospital and several biotech companies. So we'll be able to tap into the best science, the best novel ideas and the best researchers to address such complex medical diseases as CKD and NASH.
How are you innovating when it comes to life-changing type 2 diabetes treatments of tomorrow?
Our center’s goal is to slowly move from simply managing patients with type 2 diabetes to creating new medications that could someday cure some of these disease-related complications for good.
A perfect example of this is NASH, a type of liver disease common among diabetic patients. It’s caused by an accumulation of fat in the liver, triggering an inflammatory process that in some patients can lead to scarring of the liver, liver cancer and cardiovascular disease. Unfortunately, there are currently no treatments for the disease, which is why we’re hard at work trying to design a treatment that could directly address the disease process in patients with the highest risk.
I’m also very excited about our work with CKD. Nearly half of all people with type 2 diabetes develop it, putting themselves at increased risk of kidney failure and cardiovascular disease. Treatment right now is limited to drug-based management, dialysis and kidney transplantation. We’re trying to create a treatment that could repair some of the early damage from CKD, so that your kidneys can keep filtering as they should. We’re also researching ways to encourage the kidneys to regrow healthy cells to replace older, damaged ones.
We’re also exploring the idea of a once-in-a-lifetime treatment for type 2 diabetes complications, just as some people undergo a once-in-a-lifetime CAR-T therapy for their cancer. One reason why patients with CKD and NASH do poorly is because they are noncompliant. Taking a pill once a day every day for the rest of your life is hard. But if you could perform therapy early on, when the complications are still in their infancy, there's tremendous potential when it comes to improving quality of life.
We’re hoping to use precision medicine to revolutionize metabolic medicine the same way it’s revolutionized oncology. If you’re diagnosed with breast cancer, for example, physicians often recommend an individualized treatment, based on a tumor’s specific phenotype or physical characteristics. But with type 2 diabetes and its related complications, there’s often a one-size-fits-all treatment given to patients, even though not everyone responds in the exact same way.
Our mission is to change that.