Johnson & Johnson Bets $2.84 Billion on Left Atrial Appendage Closure Market with Laminar Acquisition

Dec 01, 2023 16:10 CST Updated 16:10

Johnson & Johnson

Medical Device R&D and Manufacturer

Source of the article:Heart NotCome;Editor:Liu Xinyi

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Heart Future

On November 30, 2023, Johnson & Johnson MedTech (the medical device business segment of Johnson & Johnson, NYSE: JNJ) announced the completion of its acquisition of Laminar, a company focused on developing innovative left atrial appendage (LAA) closure technologies for non-valvular atrial fibrillation, for an upfront payment of $400 million (approximately 2.84 billion RMB). Laminar was founded in the United States in 2019.

# Acquisition Details

Johnson & Johnson stated that the $400 million figure might be slightly adjusted, and additional milestone payments will be made based on Laminar's clinical and regulatory performance following the acquisition.Laminar to Be Integrated into Biosense Webster, a Johnson & Johnson Subsidiary Specializing in Cardiac Electrophysiology。In addition, after acquiring Laminar, Johnson & Johnson will adjust its expected adjusted earnings per share for the fiscal year 2023. The acquisition requires payment for ongoing research and development expenses, which will reduce the operational and reported adjusted earnings per share by approximately $0.17 compared to the previously issued guidance. Furthermore, this asset acquisition is expected to have a negative impact of approximately $0.15 on earnings per share in the fiscal year 2024.

# Atrial Fibrillation and Left Atrial Appendage Occlusion

Now,Globally, approximately 38 million patients suffer from atrial fibrillation (AFib)., the left atrial appendage (a small pouch-like附属物 extending from the left atrium) in patients with atrial fibrillation is prone to thrombus formation.Clinical studies show that over 90% of thrombi in patients with atrial fibrillation are related to the left atrial appendage. After a thrombus forms in the left atrial appendage, it can travel through the bloodstream to various organs in the body. If the thrombus blocks an artery in the brain and obstructs blood flow, it can cause ischemic stroke, commonly known as "stroke."Patients with atrial fibrillation are more than five times as likely to have a stroke as ordinary people.

Therefore, the American College of Cardiology (ACC), the American Heart Association (AHA), and the Society of Thoracic Surgeons (STS) all recommend that patients with atrial fibrillation should undergo left atrial appendage occlusion before concurrent cardiac surgery.Laminar estimates that the market size for left atrial appendage closure is expected to reach $2 billion by 2025.

Generally speaking, the surgical principle of left atrial appendage closure is to use a minimally invasive method to compress the closure device into a thin tube, which is then delivered through blood vessels to the left atrial appendage. After releasing the occluder, the opening of the left atrial appendage is blocked to prevent the detachment of thrombi within it.

But Laminar is developingNew Therapy Blocks the Left Atrial Appendage Through Rotational ManipulationPatients with atrial fibrillation are often recommended to take oral anticoagulants to reduce the risk of stroke, but there areNearly 40% of patients with atrial fibrillation cannot take blood anticoagulants long term.Laminar's system will bring them a new non-drug treatment method.

# Laminar Left Atrial Appendage Occlusion System

Overall, Laminar's left atrial appendage occlusion system can be divided into two parts, one of which isDelivery system with a diameter of 18F(Transseptal puncture to reach the left atrial appendage), as shown in the figure below:

Part ofImplant(Currently available in 12mm and 16mm sizes.) The implants are divided intoHead (Ball)AndLock (Lock) Two PartsAfter the implant reaches the left atrial appendage via the delivery system, the doctor rotates the "head" of the implant to seal the left atrial appendage, then secures the "lock," completing the procedure.

The size of the lock buckle compared to ordinary blocking fabricsMuch smaller。

Specific Surgical Operation DemonstrationSee the video below. Translation for reference:

Recently, Laminar about this occlusion systemThe pivotal study has received FDA approval., the study is planned to begin enrollment in early 2024. Previously, the early feasibility study of this device covered 45 patients. An article published in the summer this year in the journal *JACC: Cardiovascular Interventions* indicated,Fifteen patients had no safety issues within 12 months post-operation, and the left atrial appendage was successfully closed at 45 days.。

Jasmina Brooks, President of Biosense Webster, said, "Laminar's innovative approach will expand our product portfolio in this high-growth market and strengthen our electrophysiology and echocardiography businesses."

Jasmina Brooks

# Overseas Left Atrial Appendage Closure Market

In the left atrial appendage occlusion market, the main products from foreign countries includeBoston Scientific's WATCHMAN™(First approved by the FDA in 2015),Abbott's Amplatzer™ Amulet™(Approved by FDA in 2021),AtriCure's AtriClip(First approved by the FDA in 2010), and a few days ago, the newly addedMedtronic's Penditure™(Approved by the FDA in 2023, acquired from Syntheon). (The products correspond to the figure below in the order described, from left to right, top to bottom.)

WATCHMAN™ has always been an important source of performance for Boston Scientific.The company believes that the current market value of left atrial appendage closure procedures is $1.4 billion and predicts that this figure could quadruple to exceed $6 billion by 2030.The company's latest generation WATCHMAN FLX™ Pro was approved by the FDA in September 2023.

Karim Bandali, President of Medtronic's Cardiac Surgery business, stated: "The U.S. left atrial appendage surgery market has approximately 150 million patients.。”

# About Biosense Webster

Biosense Webster is a company formed by Johnson & Johnson after acquiring Cordis Webster for $1.8 billion and Biosense for $400 million in 1996. CurrentlySpecializing in Johnson & Johnson's electrophysiology businessAt that time, Cordis Webster's core products, catheters and angioplasty balloons, helped further enrich Johnson & Johnson's cardiac stent product line. Biosense, founded in 1993 by Harvard University, was the company that launched the world's first 3D cardiac electrophysiological mapping system.

The company's products are divided into six categories:3D Navigation System, Diagnostic Catheter, Therapeutic Catheter, Ultrasound Equipment, Interventional Devices, Generator。

In May this year, Johnson & Johnson Biosense Webster announced the appointment of Jasmina Brooks as President.

In August, Biosense Webster officially announced that multiple cardiac ablation products had been approved by the FDA for use without a fluoroscopy navigation system, indicating that Johnson & Johnson has begun to make efforts in the electrophysiology field.

Overseas Cardiovascular Devices:

Products of Chinese Cardiovascular Companies: