Meet Dr. Puneet Agarwal, Medical Director, Medpace
Medpace is pleased to announce that Dr. Puneet Agarwal has joined Medpace’s respiratory medical leadership team.
Dr. Agarwal is a certified pulmonologist with postgraduate residency and MD from the University of Delhi followed by RCP (Royal College of Physicians) Edinburgh accredited fellowship from Aberdeen Royal Infirmary, UK. Dr. Agarwal has extensive experience in both inpatient and outpatient management of patients with general and respiratory disorders, including rarer conditions. His experience spans from treating tuberculosis to critically unwell immunocompromised patients with complex conditions and opportunistic pulmonary infections. Prior to joining Medpace, he worked as a Principal Investigator on Phase 2/3 clinical trials.
In this brief interview, we learn more about his background and the expertise that Dr. Agarwal brings to Medpace.
Tell us about your background: what expertise do you bring to Medpace?
During my postgraduate residency and fellowship, I received extensive training and gained experience in managing patients with asthma, COPD, interstitial lung diseases, pulmonary hypertension, allergies, pleural disorders, and sleep apnoea. Moreover, I was trained in critical care medicine and managed patients with ARDS, type 2 respiratory failure, poisoning, severe pneumonia, and sepsis. Part of my training was devoted to research in allergic bronchopulmonary aspergillosis where I developed interest in fungal lung spectrum. Over the years, I have developed expertise in performing endobronchial and thoracic ultrasounds, and pleural procedures, including thoracoscopy.
I have practiced medicine in rural parts of India managing malnutrition, tuberculosis, malaria, and smoking cessation. As a member of tuberculosis control program and ambassador of the university, I conducted open public lectures and imparted knowledge on healthy practices to the most deprived population living at more than 2500 meters in the Himalayas.
While working at NHS in the UK, I developed further interest in clinical research. I joined as an investigator on a Long-COVID study and later moved to become a Principal Investigator working across multiple therapeutic areas, including Phase 2/3 studies in amyloidosis, hypertension, vaccines, and airway diseases.
I have a strong clinical background in general, respiratory, and critical care medicine along with pharmaceutical industry experience as a Principal Investigator. With understanding of ICH GCP (Good Clinical Practice) guidelines and local regulations, I play a key role as a Medical Monitor in accelerating drug development while keeping the safety of the participants paramount.
What drew you to Medpace?
Medpace is a highly reputable global CRO with the mission to accelerate drug development. The full-service model provides an integrated and efficient platform for executing clinical research. The medical team is embedded early in the life cycle of the drug providing valuable insights and guidance from inception to the clinical study report development. I am thrilled to be a part of this organization propelling drug development and my career simultaneously.
What challenges, considerations, or risks are specific to respiratory clinical development?
Respiratory diseases are among the leading causes of deaths globally with COPD ranked 3rd. Despite enormous unmet medical needs, respiratory medicine appears to have fewer new approved therapies compared to other therapeutic areas. A major challenge is the high attrition rate during drug discovery due to lack of efficacy and safety issues leading to increased cost of drug development. Preclinical studies poorly predict human conditions hence an early proof of concept studies should help to reduce the cost if a drug fails earlier in the development. There is a challenge to develop more predictive preclinical animal models that can replicate the unique pathophysiology of respiratory diseases. Finally, we need greater harmonization between academia, pharmaceutical industry, and regulatory agencies to ensure smooth translation of a drug discovery to a useful clinic treatment.
From a clinical development standpoint, what new innovations are you most excited about?
Patients with chronic respiratory conditions have a high symptom burden leading to poor quality of life. Targeted therapies and precise drug delivery systems are crucial to achieve optimal therapeutic outcomes while minimizing systemic side effects in patients with inflammatory airway diseases such as asthma and COPD. Nanoparticles based drug delivery system are engineered particles of nanometer scale that deliver drug to the target cells in the lungs with improved bioavailability and reduced toxicity over conventional drug delivery system. These are exciting prospects in respiratory medicine and would provide benefit to the patients.
Biologics have recently transformed the treatment of Type 2 asthma with recent evidence suggesting newer biologics could reduce the annualized exacerbation rate and improve lung function in former smokers with COPD. Novel targets are also being identified which may offer a potential for more personalized and targeted therapies in the future.
Finally, gene therapy is an encouraging alternative therapy in rarer respiratory conditions such as cystic fibrosis, alpha-1 antitrypsin deficiency (AATD), and primary ciliary dyskinesia (PCD) without any curative treatment. While promising advances have been made over the last decades, the absence of clinically available lung-directed genetic therapies highlights the difficulties associated with this effort. These newer treatments may revolutionize the landscape of respiratory therapeutics with improved patient outcomes and reduce healthcare burden.
What motivates you and your interest in clinical research – specifically in respiratory?
Three out of the six causes of deaths worldwide are lung diseases – COPD, lower respiratory tract infections, and lung cancer. Apart from killing millions of people every year, lung disease also causes distressing symptoms and disabilities. Recently, we all witnessed how COVID-19 infection led to millions of deaths worldwide. Moreover, systemic diseases like systemic sclerosis can affect lungs while certain drugs may cause lung toxicity. Through my work at Medpace, I will utilize my extensive medical training and years of clinical and research experience to contribute towards the development of advanced novel therapeutics in respiratory medicine, which will help respiratory patients worldwide.