Printer Friendly Printed from http://www.researchandmarkets.com/reports/328999 Metabolic Syndrome - Multiple Definitions Complicate Treatment Description: It is estimated that there are nearly 86 million Metabolic Syndrome patients in the six major markets. Although the patient pool in need of treatment for Metabolic Syndrome is large, the lack of an approved indication for Metabolic Syndrome, the lack of a consensus definition and the aversion of physicians to pharmacotherapy limit the size of the Metabolic Syndrome market, considerably Scope of this title: of this report: - Determination of the prevalence of Metabolic Syndrome and its component conditions - Evaluation of physician awareness of Metabolic Syndrome and its importance, and of physician perceptions of treatment options for the condition - Assessment of the potential of existing drug classes and developmental compounds in the treatment of Metabolic Syndrome - Understanding of the critical issues affecting the Metabolic Syndrome market Report Highlights The lack of a consensus definition for Metabolic Syndrome is complicating the diagnosis and management of patients. Lifestyle intervention may not be the most rational approach when treating Metabolic Syndrome patients. The significant patient potential and unmet need characteristic to the Metabolic Syndrome market are counterbalanced by a significant number of challenges. Reasons to order your copy: - Target physicians more effectively, through an understanding of prescribing behavior and its influences - Assess the impact that the different definitions of the condition have in the management of Metabolic Syndrome - Recognize lucrative target populations, in terms of unmet need and patient potential, in order to successfully position developmental products Contents: Chapter 1 Executive summary Scope of the analysis 3 We insight into the Metabolic Syndrome market 5 The lack of a consensus definition for Metabolic Syndrome is complicating the diagnosis and management of patients. 6 The prevalence of Metabolic Syndrome is driven by the obesity epidemic. However, its great diversity makes it hard to identify treatment targets. 8 Lifestyle intervention may not be the most rational approach when treating Metabolic Syndrome patients. 9 The significant patient potential and unmet need characteristic to the Metabolic Syndrome market are counterbalanced by a significant number of challenges. 11 Chapter 2 Introduction and scope Coverage of the Stakeholder Insight Survey 23 Chapter 3 Country treatment trees Introduction to the treatment trees 25 US 27 France 34 Germany 41 Italy 48 Spain 55 UK 62 Chapter 4 Definition of metabolic syndrome Background 69 Pre-diabetic population 70 Metabolic Syndrome 70 Confusion over syndrome name 70 Disease definition 71 Pathogenesis 73 Clinical criteria for diagnosis 75 Controversy surrounding definitions 84 Metabolic Syndrome as a marker for cardiovascular disease 90 Progression of Metabolic Syndrome to disease/events 93 Insulin resistance and its associated conditions 99 Insulin resistance and obesity 100 Insulin resistance and aging 102 Insulin resistance and dyslipidemia 102 Insulin resistance and hypertension 103 Insulin resistance and thrombosis 104 Insulin resistance and advanced glycation end products 104 Insulin resistance and the hepatic insulin-sensitizing substance effect 105 Detection, screening and diagnosis – a topic of debate 107 Diagnosis of insulin resistance 108 IGT versus IFG 109 Impact on drug development 113 Who should be screened? 114 Screening tests 115 Other considerations 116 Chapter 5 Epidemiology of metabolic syndrome Disease definition and classification 117 Prevalence of Metabolic Syndrome 117 Metabolic Syndrome prevalence methodology 118 US 119 France 119 Germany 119 Italy 120 Spain 120 UK 120 Impaired fasting glucose prevalence 121 Impaired fasting glucose prevalence methodology 123 Dyslipidemia prevalence 124 Hypercholesterolemia prevalence methodology 125 US 126 France 126 Germany 127 Italy 127 Spain 127 UK 128 Hypertension prevalence 128 Hypertension prevalence methodology 129 US 130 France 131 Germany 131 Italy 131 Spain 132 UK 132 Obesity prevalence 132 Obesity forecasts 135 Obesity prevalence methodology 138 US 138 France 138 Germany 139 Italy 139 Spain 139 UK 139 Forecast methodology 139 Prevalence of obesity in juveniles 140 Chapter 6 Segmentation of metabolic syndrome patients Breakdown by demographic characteristics 142 Breakdown by risk factor 144 High risk patient profile 146 Treatment guidelines 152 Importance of treating Metabolic Syndrome 155 Chapter 7 Lifestyle management versus pharmacological treatment Management of Metabolic Syndrome 157 Lifestyle Management 160 Lifestyle management and clinical practice. 162 Delayed diagnosis of Metabolic Syndrome 163 Therapeutic Lifestyle Changes (TLC) 164 Chapter 8 Prescribing trends Current role for pharmacological treatment 167 Approaches to the pharmacological treatment of Metabolic Syndrome 170 Overall prescribing trends 171 Obesity 174 Xenical 175 The XENDOS study shows orlistat reduces risk of type 2 diabetes 176 The FDA approves the use of orlistat in adolescents 177 The European Commission approves label extension 178 Meridia 180 Behavior therapy and sibutramine for the treatment of adolescent obesity 181 STORM trial shows weight-maintenance success after weight loss is positively influenced by sibutramine and leisure-time activity. 182 Sibutramine has a positive effect on clinical and metabolic parameters in obese patients with polycystic ovary syndrome (PCOS) 182 Sibutramine effective in the treatment of binge-eating disorder 183 No benefits shown in health-related quality of life study in sibutramine-treated obese patients with type 2 diabetes 184 SCOUT study 184 Acomplia 185 Clinical trial data 186 Prescription trends 189 Dyslipidemia 191 Statins 192 ASCOT 193 AVALON 194 Ezetimibe 195 Combination therapies 196 Vytorin 196 Caduet 197 Fibrates 197 Nicotinic acid derivatives 198 Prescription trends 199 Hypertension 200 ARBs 200 ACEIs 201 Beta-blockers (BBs) 204 Calcium-channel blockers (CCBs) 206 Diuretics 207 Prescription trends 208 Diabetes 211 Biguanides 211 Sulfonylureas 212 Thiazolidinediones 212 Alpha glucosidase inhibitors 214 Insulin 214 Prandial Glucose Regulators 218 Prescription Trends 219 Pill Burden 221 Metabolic Syndrome and disease prevention 223 Insulin Resistance 223 Obesity 224 Awareness of developmental classes of compounds 226 Chapter 9 Critical issues affecting metabolic syndrome Unmet needs - Challenges 228 Clinical unmet needs - challenges 228 Consensus definition 228 Efficacy goals not met by current treatment 229 Need to curb the epidemic rise in the prevalence of Metabolic Syndrome. 230 Avoiding compensatory feedback mechanisms 230 Need to take advantage of synergies between drugs, diet, exercise and behavior 231 If possible, address underlying cause(s) to the Metabolic Syndrome 231 Commercial unmet needs-challenges 232 Metabolic Syndrome not approved as indication 232 Prevention of disease in “healthy” subjects associated with higher demands on side effects and tolerability 232 Safety 232 Outcome studies will be required to demonstrate benefits of CVD and diabetes prevention 233 Clinical trial issues 234 APPENDIX A BIBLIOGRAPHY References 240 APPENDIX B PRIMARY RESEARCH Physician research methodology 259 Physician sample breakdown 259 US 259 France 260 Germany 261 Italy 262 Spain 263 UK 264 Questionnaire 265 1. Patient Segmentation and Diagnosis 267 2. Treatment of Metabolic Syndrome 276 3. Future developments 285 4. Patient outcomes 289 Ordering: Order Online - visit http://www.researchandmarkets.com/reports/328999 Order by Fax - using the order form below Order By Post - print the order form below and send to Research and Markets, Guinness Centre, Taylors Lane, Dublin 8, Ireland. Page 1 of 2 Printed 30/08/2008 17:12:26 Fax Order Form To place an order via fax simply print this form, fill in the information below and fax the completed form to the number at the bottom of this page. If you have any questions please email help@researchandmarkets.com Order information Please verify that the product information is correct and select the format you require. Product Name: Metabolic Syndrome - Multiple Definitions Complicate Treatment Web Address: http://www.researchandmarkets.com/reports/328999 Office Code: OCHGMLPQSPS Report formats Please enter the quantity of the report format you require. 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