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Pipeline perspectives - Peripheral artery disease Poor disease awareness hinders new agents

http://www.companiesandmarkets.com/Summary-Market-Report/pipeline-perspectives-peripheral-artery-disease-poor-disease-awareness-hinders-new-agents-30295.asp


Report Summary

Introduction

Peripheral artery disease, sometimes also referred to as peripheral vascular disease, is atherosclerosis in peripheral regions, which can lead to loss of blood flow to the limbs, and can result in loss of life, limb amputation and cardiovascular events. The current pharmacological treatment options are limited, and there are large unmet needs associated with the disease.

Scope

  • Evaluate therapies under development for peripheral artery disease (PAD)
  • A detailed clinical and commercial assessment of all key emerging therapies
  • Epidemiological based sales forecasts for key late-stage developmental heart failure agents in the seven major markets to 2016


  • Highlights

    PAD is severely undertreated and underdiagnosed. Despite the high prevalence (23.4 million subjects by 2016) and grave consequences, such as cardiovascular events, amputations and death, PAD is not considered as "fascinating" as coronary artery disease and the lack of PAD awareness even among physicians is staggering.

    Drug therapy plays a limited role in the management of PAD, due to the restricted treatment options. For intermittent claudication (IC) patients the mainstay of pharmacological treatment is prevention of CV events with antiplatelets and statins. Cilostazol (Pletal), an antiplatelet, is recommended as first-line therapy for claudication

    The new agents in development for PAD are primarily as secondary indications. This is due to the issues new agents will face reaching the underdiagnosed, undertreated patient population. Overall, there are very few clinical trials to develop PAD agents, and the trials are very much underpowered.

    Reasons to Purchase

  • Understand patient segmentation relevant to pipeline products and analyze competitive environment at time of product launch
  • Justify go/no-go decisions on basis of potential return on investment
  • Utilize product profiles to aid pricing and reimbursement decisions

  • Table of Contents

    Table of Contents
    ABOUT DATAMONITOR HEALTHCARE 2
    About the Disease pharmaceutical analysis team 2
    CHAPTER 1 EXECUTIVE SUMMARY 4
    Scope of the analysis 4
    Datamonitor insight into the PAD market 5
    Key metrics 7
    Datamonitor Pipeline Assessment Summary 9
    CHAPTER 2 PIPELINE OVERVIEW AND DYNAMICS 12
    Pipeline overview 12
    The PAD pipeline shows diverse mechanisms of action 16
    The PAD pipeline is rich in Phase II candidates 17
    Numerous companies have their stake in the R&D landscape 18
    Key companies involved in the PAD pipeline 19
    Key R&D company strategies 20
    PAD as a secondary indication 20
    Identifying suitable patient groups 21
    CHAPTER 3 Peripheral artery disease - MARKET POTENTIAL 22
    Definition of Peripheral Artery Disease 22
    Intermittent claudication 23
    Critical Limb Ischemia 23
    Consequences of PAD 23
    Segmentation of PAD 24
    Epidemiology of PAD 26
    Forecasts of PAD 27
    Unmet needs in PAD 28
    Major obstacles between the drugs and the market 29
    Patient awareness of PAD 29
    Physician awareness of PAD 30
    Clinical unmet needs 32
    More treatment options required 32
    Drugs trialed in patients with concomitant disease 33
    Drugs with no / lower resistance 34
    Drugs with greater efficacy 34
    Ability to prevent cardiovascular events and amputations 35
    More cost-effective care 36
    Drugs with fewer side-effects 37
    CHAPTER 4 R&D APPROACH 38
    Classification of pipeline products 38
    Gene therapy 41
    Antiplatelets 43
    Thrombolytics 44
    Prostaglandins 45
    Others 47
    Clinical trial design in PAD 47
    Absolute claudication distance/initial claudication distance 47
    Ankle to brachial index 48
    Imaging 48
    Pulse volume recording waveform analysis 48
    Duplex arterial imaging or ultrasound imaging 48
    Angiography 49
    Improvement in symptoms and quality of life 49
    Long-term morbidity and mortality 49
    Potential areas for improvement in the clinical trial design 50
    Trialing of new agents in specific patient subsets 50
    Size of clinical trials 50
    Outcome trials 51
    CHAPTER 5 ANTIPLATELETS LATE-STAGE DRUG ANALYSIS & FORECASTS 52
    Overview for antiplatelets 52
    Pipeline summary 52
    Definition of current comparator therapy 54
    Parogrelil (INDI-702) 57
    Drug overview 57
    Clinical trial data 58
    Patient potential 59
    Marketing factors 60
    Conduct more trials on efficacy and resistance 60
    Satisfaction of unmet needs 61
    Forecasts to 2016 62
    Datamonitor drug assessment summary 62
    CHAPTER 6 PROSTAGLANDINS LATE-STAGE DRUG ANALYSIS & FORECASTS 64
    Overview for prostaglandins 64
    Pipeline summary 64
    Definition of current comparator therapy - Prostavasin 66
    Liprostin (liposomal prostaglandin E-1, Endovasc) 68
    Drug overview 68
    Clinical trial data 68
    Patient potential 69
    Marketing factors 70
    Satisfaction of unmet needs 71
    Forecasts to 2016 72
    Datamonitor drug assessment summary 72
    BIBLIOGRAPHY 74
    Epidemiology 74
    Clinical trial data and other 75
    APPENDIX A 78
    Methodology 78
    Datamonitor forecast methodology 78
    Epidemiology forecasts 78
    Product forecasts 81
    APPENDIX B 84
    About Datamonitor 84
    About Datamonitor Healthcare 84
    Datamonitor Healthcare's therapy area capabilities 85
    About the Disease analysis team 86
    Disclaimer 87
    List of Tables
    Table 1: Forecast prevalence of PAD (excluding borderline PAD) in the seven major markets (000), 2007-2016 7
    Table 2: R&D pipeline for the treatment of PAD, 2007 14
    Table 3: PAD pipeline by company, 2007 18
    Table 4: Fontaine classification system for PAD 24
    Table 5: Rutherford's classification of PAD 24
    Table 6: Forecast prevalence of PAD (excluding borderline PAD) in the seven major markets (000), 2007-2016 27
    Table 7: PAD pipeline agents by drug class 39
    Table 8: Antiplatelets for the treatment of PAD 52
    Table 9: Otsuka and Pfizer's Pletal: key facts 55
    Table 10: Ability of parogrelil to satisfy the unmet needs, 2007 61
    Table 11: Prostaglandins for the treatment of PAD 64
    Table 12: Prostavasin: key facts 66
    Table 13: Ability of Liprostin to satisfy the unmet needs, 2007 71
    Table 14: Forecast prevalence of PAD (including borderline PAD) in the seven major markets (000), 2007-2016 80
    Table 15: Datamonitor drug assessment parameters 82
    List of Figures
    Figure 1: Sales forecasts for antiplatelets, 7 major markets, 2007-16 8
    Figure 2: Sales forecasts for prostaglandins, 7 major markets, 2007-16 8
    Figure 3: Datamonitor drug assessment summary of antiplatelets in development for PAD, 2007 9
    Figure 4: Datamonitor drug assessment summary of prostaglandins in development for PAD, 2007 10
    Figure 5: R&D Pipeline for PAD agents, 2007 12
    Figure 6: Main classes of agents in development for PAD, 2007 16
    Figure 7: Percentage of R&D products in each Phase of development for PAD, 2007 17
    Figure 8: Breakdown of PAD population 25
    Figure 9: The most important unmet needs in PAD, 2007 28
    Figure 10: Datamonitor drug assessment summary of antiplatelets in development for PAD, 2007 53
    Figure 11: The percent mean improvement in maximal walking distance in trials with cilostazol 57
    Figure 12: Sales forecast for parogrelil in PAD to 2016, seven major markets 62
    Figure 13: Datamonitor's competitive positioning analysis of parogrelil, 2007 63
    Figure 14: Datamonitor drug assessment summary of prostaglandins in development for PAD, 2007 65
    Figure 15: Sales forecast for Liprostin in PAD to 2016, seven major markets 72
    Figure 16: Datamonitor's competitive positioning analysis of Liprostin, 2007 73
    Figure 17: Datamonitor drug assessment summary of pipeline molecular targeted therapies in development for hematological malignancies, 2007 83