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Pipeline Insight: Antidyslipidemics - The Power of Two

Published by: Datamonitor

Published: Aug. 9, 2005 - 144 Pages


Table of Contents


ABOUT DATAMONITOR HEALTHCARE

About the cardiovascular pharmaceutical analysis team




CHAPTER 1 EXECUTIVE SUMMARY

Datamonitor insight into the antidyslipidemics market


R&D pipeline dynamics

Guideline recommendations for an aggressive treatment approach emphasizes a need for more treatment options

Pfizer's atorvastatin + torcetrapib combination to become a blockbuster drug

JTT-705- the most promising adjunct in development




CHAPTER 2 PIPELINE OVERVIEW & FUTURE FOCUS

Pipeline overview


PPAR agonists dominate the antidyslipidemic pipeline

Greatest number of drugs in Phase II of development

Heavy investment from Japanese-based pharmaceutical companies

Pfizer's strategy to success


Pfizer protecting its revenue

Pfizer's strategy under scrutiny

Thought needs to be given to pricing strategy


Merck - the loss of Zocor's patent


Diversifying its portfolio

In-licensing

Expansion

Streamlining

HeartPro and Vytorin





CHAPTER 3 PIPELINE DYNAMICS

Definition of dyslipidemia


What is dyslipidemia?


Segmentation of dyslipidemia


Markers for dyslipidemia

Main types of dyslipidemia


Hypercholesterolemia

Familial hypercholesterolemia

Hypertriglyceridemia

Familial hypertriglyceridemia

Mixed dyslipidemia



Epidemiology of dyslipidemia

The greatest unmet need in dyslipidemia according to key opinion leaders, is for drugs with the ability to prevent or reverse atherosclerosis


Drugs need to prevent or even reverse the progression of atherosclerosis

Drugs with novel mechanisms of action

Drugs with increased efficacy in lowering LDL and increasing HDL

More long-term data is required to support primary and secondary prevention of acute CVD events.

More combination therapies are needed

Additional statin safety studies not required




CHAPTER 4 R&D APPROACH

Classification of pipeline products


Statins and statin combinations


Statins dominate the antidyslipidemic market

Mechanism of action

Atorvastatin + CETP inhibitor

Fibrates - PPAR alpha agonists

Fibrate + biguanide


Other non-statin therapies


Acyl-CoA cholesterol acetyltransferase (ACAT) inhibitors

Ileal bile acid transport (IBAT) inhibitors

Lipoprotein lipase activator

Microsomal triglyceride transfer (MTP) inhibitors

Squalene synthetase inhibitor

Bile acid reabsorption inhibitor

Adenosine A1A receptor agonist

Apolipoprotein B100 antagonist

Dual PPAR agonists

PPAR delta agonist

VCAM inhibitor

Hypolipemic agent

Lipoprotein regulator

Transcription factor inhibitor

Cholesterol absorption inhibitors



Clinical trial design in dyslipidemia


Short term endpoints: controlling cholesterol levels

Long term endpoints: reduction in morbidity and mortality




CHAPTER 5 SINGLE-PILL STATIN COMBINATION LATE-STAGE DRUG ANALYSIS & FORECASTS

Overview for single-pill statin combination drugs


Pipeline summary

Definition of current comparator therapy


Pfizer's Lipitor remains the current comparator therapy


Lipitor's rise to prominence


KS-01-019


Clinical trials still underway

Good patient potential

Marketing of Advicor provides Kos with experience

KS-01-019 performance will depend on its long-term data

SWOT analysis

Forecast to 2015


Atorvastatin + torcetrapib


Extensive Phase III trial underway

Significant increases in HDL cholesterol seen in Phase II trials

Elevations of 16-91% in HDL are seen in Phase I trials

Good patient potential if it can prove to reduce the progression of CHD

Marketing strategy aims to help Pfizer retain monopoly

The overall performance of atorvastatin + torcetrapib combination is lower than atorvastatin

SWOT analysis

Forecast to 2015


Datamonitor drug assessment summary




CHAPTER 6 FIBRATES AND FIBRATE COMBINATIONS LATE-STAGE DRUG ANALYSIS AND FORECASTS

Pipeline summary

Fenofibrate is the current comparator therapy

Fenofibrate + metformin single-pill combination


No clinical trial data

Limited patient potential

Previous experience in marketing fenofibrate and metformin should enable Merck and Fournier to market the drug successfully

Overall performance rated lower than fenofibrates

SWOT analysis

Forecast to 2015


LCP Feno


LCP Feno met both primary and secondary objectives in clinical trial

LCP Feno offers another choice of fibrate for physicians

Marketing partner for LCP Feno is unknown

LCP Feno's performance rated lower than fenofibrate

SWOT analysis

Forecast to 2015


Datamonitor drug assessment summary




CHAPTER 7 ADJUNCTIVE THERAPY LATE STAGE ANALYSIS

Pipeline summary

Three different comparator therapies

Implitapide


Phase II trials are ongoing

Phase I showed significant lowering of LDL of up to 58%

Potential alternative to statins

Co-marketing deal may boost sales

Implitapide's performance rated lower than atorvastatin

Forecasts to 2015


JTT-705


34% increase in HDL in Phase II clinical trials

Excellent patient potential as adjunctive therapy

Marketing factors

JTT-705 shows better potential than Niaspan

Forecast to 2015


FM VP4


Phase I trials show excellent safety profile

Phase II trials still underway

Potential as a safe top-up drug

FM VP4 will require a marketing partner

Overall performance rated less than Zetia

Forecast to 2015


Datamonitor drug assessment summary



CHAPTER 8 COMPARATIVE FORECASTS

Comparative analysis




CHAPTER 9 INNOVATIVE EARLY-STAGE PROJECTS

Gene therapy appears to be a key therapy in preclinical development for dyslipidemia




APPENDIX A

Epidemiology methodology


Datamonitor forecast methodology

Methodology

US

Japan

France

Germany

Italy

Spain

UK

Datamonitor drug assessment summary


Contributing experts

Bibliography


Epidemiology sources


US

Japan

France

Germany

Italy

Spain

UK


Clinical trial data


Report methodology

About Datamonitor


About Datamonitor Healthcare


Datamonitor Healthcare's therapy area capabilities


About the cardiovascular analysis team


Disclaimer


List of Tables

Table 1: R&D pipeline in the antidyslipidemic market, 2005

Table 2: Antidyslipidemic pipeline, 2005

Table 3: Phase of development of products in each class, 2005

Table 4: Composition of the antidyslipidemic R&D pipeline by company.

Table 5: Key changes to lipid levels between the NCEP II and NCEP III

Table 6: Epidemiology overview of dyslipidemia, 2005-15

Table 7: Epidemiology figures by age for the seven major markets, 2005

Table 8: Total epidemiology figures by age for the seven major markets, 2005

Table 9: R&D pipeline in the antidyslipidemic market, 2005

Table 10: Key products in late-stage R&D pipeline for single pill statin combination drugs, 2005

Table 11: Global sales of the leading branded statins, 2003-04

Table 12: Lipitor: key facts

Table 13: Global sales forecasts for simvastatin + Niaspan, 2007-15

Table 14: Factors affecting the revenues of simvastatin + Niaspan, 2007-15

Table 15: Phase II trial results of atorvastatin + torcetrapib combination

Table 16: Global sales forecasts for atorvastatin + torceptrapib, 2008-15

Table 17: Factors affecting the revenues of atorvastatin +torcetrapib, 2008-15

Table 18: Research, clinical and commercial attractiveness summary for pipeline single-pill statin combination drugs

Table 19: Key products in late-stage R&D pipeline for HDL targeting agents & combinations, 2005

Table 20: Lipanthyl/Tricor: key facts

Table 21: Global sales forecasts for metformin + fenofibrate, 2007-15

Table 22: Factors affecting the revenues of metformin + fenofibrate, 2007-15

Table 23: Global sales forecasts for LCP Feno, 2006-15

Table 24: Factors affecting the revenues of LCP Feno, 2010-15

Table 25: Research, clinical and commercial attractiveness summary for pipeline fibtates and fibrate combination drugs

Table 26: Key products in late-stage R&D pipeline for HDL targeting agents & combinations, 2005

Table 27: Niaspan: key facts

Table 28: Zetia: key facts

Table 29: Global sales forecasts for implitapide, 2009-15

Table 30: Factors affecting the revenues of implitapide, 2009-15

Table 31: Global sales forecasts for JTT-705, 2009-15

Table 32: Factors affecting the revenues of JTT-705, 2009-15

Table 33: Global sales forecasts for FM VP4, 2008-15

Table 34: Factors affecting the revenues of FM VP4, 2008-15

Table 35: Research, clinical and commercial attractiveness summary for pipeline adjunctive therapies

Table 36: Global sales forecasts for anti-dyslipidemic drugs, 2005-15

Table 37: Drugs in preclinical development for dyslipidemia, 2005

Table 38: Datamonitor drug assessment parameters




List of Figures

Figure 1: Pipeline overview of antidyslipidemic drugs

Figure 2: Percentage of R&D products in each phase of development, 2005

Figure 3: Composition of the antidyslipidemic R&D pipeline by country, 2005

Figure 4: Composition of the antidyslipidemic R&D pipeline by company type

Figure 5: Unmet needs in the dyslipidemia market, 2005

Figure 6: Assessment of KS-01-019's performance indicators

Figure 7: KS-01-019 SWOT analysis

Figure 8: Global sales forecasts for simvastatin + Niaspan, 2007-15

Figure 9: Assessment of atorvastatin + torcetrapib's performance indicators

Figure 10: SWOT analysis of atorvastatin + torcetrapib combination

Figure 11: Global sales forecasts for atorvastatin + torceptrapib, 2008-15

Figure 12: Research/clinical and commercial attractiveness of single-pill statin combinations

Figure 13: Datamonitor's drug assessment summary for the late-phase pipeline single-pill statin combination drugs

Figure 14: Assessment of metformin + fenofibrate performance indicators

Figure 15: Metformin + fenofibrate SWOT analysis

Figure 16: Global sales forecasts for metformin + fenofibrate, 2007-15

Figure 17: Assessment of LCP Feno's performance indicators

Figure 18: LCP Feno SWOT analysis

Figure 19: Global sales forecasts for LCP Feno, 2006-15

Figure 20: Research/clinical and commercial attractiveness of fibrate and fibrate combination drugs

Figure 21: Datamonitor's drug assessment summary for the late-phase pipeline single-pill statin combination drugs

Figure 22: Assessment of implitapide's performance indicators

Figure 23: Global sales forecasts for implitapide, 2009-15

Figure 24: Assessment of JTT-705's performance indicators

Figure 25: Global sales forecasts for JTT-705, 2009-15

Figure 26: Assessment of FM VP4's performance indicators

Figure 27: Global sales forecasts for FM VP4, 2008-15

Figure 28: Research/clinical and commercial attractiveness of adjunctive therapies

Figure 29: Datamonitor's drug assessment summary for the late-phase pipeline adjunctive therapies

Figure 30: Datamonitor's drug assessment summary for the late-phase antidyslipidemic pipeline drugs

Figure 31: Example of Datamonitor drug assessment scorecard

Figure 32: Example of Datamonitor drug assessment graph

Abstract

Introduction
Datamonitor estimates that there are 267m people in the seven major markets with total cholesterol >200mg/dL and this is set to rise to 286m in 2015. The market has been dominated by statins for a number of years now, however, with updated guidelines taking a more aggressive approach to treatment, there is a need for more efficacious and safe alternatives on the market.

Scope
  • Patient potential for developmental antidyslipidemics over the period 2005-2015
  • Insight into the R&D pipeline with detailed information on drugs in development, clinical trial results and identification of suitable comparators
  • Evaluation of key players in the antidyslipidemics market and opposing company approaches to development and commercialization
  • Analysis of key antidyslipidemic drugs in development and their ability to satisfy major unmet needs and compete with existing agents
Highlights
The NCEP committee updated the guidelines in 2004, taking a more aggressive approach to the treatment of dyslipidemia to help further reduce cardiovascular risk. This in turn has increased the need for alternative drugs that can help lower LDL cholesterol to meet the new lower threshold without putting patients at risk.

The antidyslipidemic R&D pipeline is still relatively young with 91% of drugs in Phase I and II. There also appears to be a lot of investment in adjunctive therapies with approximately 69% of the drugs in the pipeline representing this class.

Datamonitor has identified Pfizer's atorvastatin + torcetrapib combination drug and Japan Tobacco's JTT-705 as the most promising drugs in the pipeline. The atorvastatin + torcetrapib combination target both LDL and HDL with a synergistic effect which means it may offer significant advantages in efficacy with improved safety.

Reasons to Purchase
  • View independent sales forecasts for drugs in late stage development for treatment of dyslipidemia
  • Examine the classes of products in development by phase and the challenges they have to face to reach the market
  • Identify early-stage antidyslipidemic compounds with high potential being developed by companies seeking a marketing partner


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