My Investment Takes: Combinostics – and the detection of neurodegenerative diseases

My Investment Takes is a weekly dive into the startups I find the most innovative & interesting.

There are no treatments for dementia.

Every 3.2 seconds, someone in the world develops dementia, and Alzheimer's Disease International estimates that the number of active cases will likely be multiplied by 2.5x by 2050, to 139 million.

Dementia is an umbrella term, covering several brain diseases, including Alzheimer’s. Dementia is a progressive disease that starts with benign symptoms such as mild loss of memory, gradually escalating to a loss of ability to have normal conversations, and as time goes by it becomes impossible to carry out daily activities by oneself. Late-stage sufferers are often bedridden, and unable to walk or eat or swallow without constant help.

While there is no comprehensive solution to the illness, we need to focus on ways to mitigate its effects, which thankfully we have. Early diagnosis is one of these ways. Patients are able to use treatments more effectively, increasing the chances for the medication and alternative therapies to take effect, and to focus on what’s important to them.


Combinostics is one such solution.

Combinostics is a Finland-based start-up that developed an advanced diagnostic platform including a set of tools to offer a quantitative assessment of brain images. Their cloud-based platform enables doctors and healthcare workers to evaluate MRI scan results against a global anonymised database.

What is Important

Dementia is a growing issue

There are 55 million people living with dementia today, and nearly 10 million new cases every year, making it the 7th leading cause of death caused by diseases. Furthermore, given its debilitating effect and subsequent high levels of dependency, dementia is a huge strain on our loved ones, health care systems, or the patients themselves.

As I mentioned earlier, we have perfected health care in western countries, and tremendous improvements are being made in Africa and Asia: our lives are longer, more productive and healthier than they used to be.  

However, these longer lives do come at a cost. 60% of people with dementia live in low and middle-income countries, and that is set to increase to 71% by 2050. Alzheimer’s Disease International predicts that China, India, South-East Asian countries and Pacific countries (Australia, New Zealand, etc.) will see faster growth in the elderly population, and as a result are likely to see a growing number of cases as well. Indeed, age is known as being the strongest risk factor, even though there are some cases of early onsets (before 65 years old) that count for 9% of cases.

What to do to mitigate it?

Mitigating dementia is extremely difficult.

As I mentioned earlier in the article, there are no treatments. Nonetheless, early detection is deemed to be the best way to mitigate some of the problems that arise with the diagnosis. Patients can go for clinical tries, get appropriate care, plan for the next months or years, and work on their mental and physical capabilities to stimulate them as much as possible. However, early detection is difficult to accomplish, as research shows that most people currently living with dementia have not yet received a formal diagnosis.

What we can all do, at all ages, is to continuously stimulate our mind and body. Regular physical activity, playing chess, talking with people and maintaining a social circle, sleep a good amount, and even playing video games. There is even an elderly e-sport team from Japan called the Matagi Snipers, aged 66 to 73, who took up video games as a way to stay mentally active!

If you need someone to play chess or video games, my messages are open.  

What I love

The technology

Let’s know talk about Combinostics.

They are the only startup providing a complete solution to neurodegenerative disorders: from early detection to disease management.

Their suite of products cNeuro® includes two solutions:

• cMRITM supports radiologists with AI-enabled, fully automated brain MRI quantification with high-quality reporting. The software is cloud-based, permits increased accuracy, and provides multiple reports automatically (clinical, simplified patient, and longitudinal). Additionally, clinicians can review brain segmentation and the volume of brain structures whilst comparing them to reference data, or look for lesions compared to the baseline. The full presentation of their platform and all of its options can be found here.
• cDSITM combines and analyses key patient data and compares it against a large anonymous database of previously diagnosed patients. Collected data includes demographics, clinical and neuropsychological tests, cMRI imaging biomarkers and other biomarkers. In conjunction, it provides a complete diagnosis and packed report, which helps clinicians estimate the trajectory of an individual based on patients of similar backgrounds

I find the technology extremely impressive.

I am not a doctor, but as an analyst, I am very fond of their model. I am always on the lookout for startups that recognise the power of constructing a database when there are none. In the healthcare sector specifically, data is often fragmented, inconsistent, unstructured and static (does not evolve with the patient’s condition), or simply non-existent. I like Combinostics because the team was able to use existing data to build its product -which is a lot harder than it sounds- with the intent of building up its own database which further differentiates their offer. As time goes by and the number of hospitals that uses their tool increase, so will the quality of their product.
 

The path forward

Combinostics was able to raise a Series A a few years ago, with the plan to expand.
The platform is set to roll out in the US and in Asia, and the team has already secured strategic partners with strong ties to Japan and the Nordics, where the elderly population is large and therefore the market as well.

They are working on regulatory approval in Japan whilst ramping up their R&D investment, and are looking for a partner in China.
The team is strong, their product line-up is excellent with a large set of future development possibilities, and I’m confident in the path they are taking.

The Questions I have for the Team

• How difficult is it to get regulatory approval in the markets you are targeting?
• Are there any new product lines you plan on developing in the pipeline?
• Which aspect of your products your users are most excited about? 

My Conviction

Combinostics has the potential to be an incredible tool in our fight against dementia. We are getting older, the need for constant medical attention will only grow and the quality of our medical tools should improve.
The Finnish startup announced the closure of its $3.9 million Series A in November 2019, spearheaded by NordicNinja and Industrifonden.

If you’re excited to check them out, take a look at their website https://www.combinostics.com, and leave a comment on this post if you have any thoughts or comments!