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Stakeholder Opinions: Respiratory Syncytial Virus (RSV) - A market yet to reach its full potentialPublished by: Datamonitor Published: Dec. 21, 2006 - 150 Pages Table of ContentsTABLE OF CONTENTS CHAPTER 1 EXECUTIVE SUMMARY 4 Scope of the report 4 Contributing experts 4 Datamonitor insight into the respiratory syncytial virus (RSV) market 5 CHAPTER 2 DISEASE BACKGROUND 12 Etiology of the RSV virus 12 RSV is easily transmitted 16 Immune response does not sufficiently protect from further infection 17 Symptoms and classification 18 Groups at risk of severe disease caused by RSV infection 20 Young children and premature infants 30 Elderly 35 People with underlying cardiac or pulmonary disease 37 Immunocompromised patients 43 Nosocomial RSV infections 44 RSV reinfection 45 The seasonality of RSV 45 Mortality is low in most risk groups 48 Hospitalization expenses make RSV infections costly 49 CHAPTER 3 DIAGNOSIS 52 Viral culture is the current gold standard 54 Polymerase chain reaction may become new gold standard 54 Antigen detection assays are fast but lack sensitivity 57 Bronchiolitis guidelines 58 CHAPTER 4 CURRENT TREATMENT AND PREVENTION OPTIONS 61 Synagis has monopoly in RSV infection prophylaxis 63 The Phase III IMpact trial showed efficacy and safety 66 Separate trial in children with congenital heart disease leads to indication expansion 68 Synagis’s cost-effectiveness is doubtful 71 Virazole’s reputation is damaged by negative trials 73 Lack of evidence for use of pharmacological symptom treatment 76 Beta2-agonists 77 Ipratropium bromide 79 Epinephrine 79 Corticosteroids 80 Non-pharmacological symptom treatments show some improvement in subpopulations 81 Bronchiolitis guidelines 82 Prescribing trends 84 CHAPTER 5 FUTURE TRENDS 88 Most important unmet need is the lack of RSV treatment and vaccines 89 Future trends in treatment 91 The antivirals class is the most advanced (Phase II) 93 RNA interference (RNAi) as antiviral is a promising approach 95 Antisense drugs not in clinical trials yet 97 An RSV treatment used in the hospital could have peak sales of $700-750 million 98 An RSV treatment used in the community could have peak sales of more than $1 billion 100 Future trends in prophylaxis 102 Future trends in vaccines 104 Types of vaccines in development for RSV 107 Strategies of a vaccination program 111 MedImmune also dominates limited RSV vaccine development 115 APPENDIX A BIBLIOGRAPHY 118 Press releases 144 APPENDIX B COMMERICALLY AVAILABLE ANTIGEN DETECTION ASSAYS 146 Disclaimer 150 AbstractIntroductionRSV mostly causes upper respiratory tract infections (URTI), resulting in the common cold. However, in certain risk groups, RSV can cause more severe lower respiratory tract infections (LRTI) leading to bronchiolitis. These risk groups include elderly people, patients with underlying pulmonary or cardiac disease, premature infants, children under four years old and immunocompromised patients. Scope Discusses disease background, providing insight in RSV epidemiology, etiology and symptoms Gives a breakdown of RSV (hospitalization) prevalence in the seven major markets Examines current diagnosis and treatment trends, providing physicians' opinions Examines the RSV pipeline by type treatment, prophylaxis and vaccines, including a short discussion of each pipeline product Highlights Some physicians do not value the importance of a correct RSV diagnosis, since there is no effective treatment available. Furthermore, the American Academy of Pediatrics does not recommend routine testing for RSV in bronchiolitis. However, there are reasons why proper diagnosis should be considered, and there is a range of tests available for that. The RSV market is currently dominated by MedImmune's Synagis, a prophylactic monoclonal antibody. As RespiGam's successor, Synagis was first launched in 1998 and now has sales of around $750 million per RSV season. Due to its high costs though, Synagis is only prescribed to a very limited group of individuals. Although the most important unmet need in RSV is an effective treatment or vaccine, many companies have discontinued their developments in this field. Only two companies have an RSV treatment in clinical development (Novartis/Arrow Therapeutics and Alnylam) and MedImmune dominates the limited vaccine development. Reasons to Purchase Gain insight into the issues of current diagnosis and treatment for RSV through key opinion leader comments Review the unmet needs and the clinical and commercial factors driving new product decisions Identify the opportunities and threats presented by the RSV pipeline and predict the future shape of the market Get Full Details About This Report >> |
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