With the recent success of Ardian’s Symplicity Renal Denervation System, drug-resistant hypertension has emerged as something of a device market “gold rush.” Some observers estimate there are now as many as 40 companies developing various device-based therapies for resistant hypertension, including most of the big names in the cardiovascular device arena – Medtronic, St. Jude Medical, Boston Scientific, Johnson & Johnson, and Covidien PLC – along with a number of start-ups, all of which are racing to stake a claim in this highly promising market. Only time will tell which companies will be successful – even Medtronic, the first player, has yet to complete its sham-controlled US trial. But the technology’s early promise, along with the sheer size of the opportunity and the acute unmet need, clearly have peaked the interest of investors, manufacturers, and physicians alike, all of whom are chasing after what one participant has called “the next biggest thing in cardiology.”

Miramar is employing a conventional product development strategy to create the first device therapy in an unconventional clinical space – hyperhidrosis, or excessive sweating. The key: a more rigorous clinical approach than usual in aesthetics. But is the market there?

Three years ago, only Ardian was publicly working on renal denervation devices for hypertension, but at last month’s ACC meeting, some said there were now anywhere from 16 to 40 companies in the space. Fast followers don’t want to miss out on an IP land grab in today’s hottest medical device space.