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Prevention of Organ Transplant Rejection: Current Therapies and Novel Strategies
Decision Resources, Inc., Aug 2005, Pages: 14
The practice of organ transplantation has expanded substantially since the first successful kidney transplant, more than 40 years ago. Despite improvements in the rate of acute organ rejection following transplantation, however, organ loss remains a problem. Approximately 50% of the $5 billion spent annually in the United States on organ transplants is spent on post-transplantation immunosuppressive therapy and/or treatment of complications following transplantation, including acute and chronic rejection.
In this report, we examine the causes of acute and chronic organ rejection and discuss the benefits and drawbacks of current treatment options. We review emerging targets for rejection therapies and discuss the strategic transition from immunosuppression to immunomodulation. Finally, we profile several drugs in clinical development that we expect will change the standard of care for transplant patients by 2010.
Business Implications
- Despite the enabling role of immunosuppressive regimens in organ transplantation, their generalized depression of the immune system
leaves transplant patients vulnerable to infections and potential malignancies that contribute to morbidity and mortality.
- Numerous challenges remain in the effort to further reduce acute organ failure, and prevention of chronic organ rejection has proved even more difficult. However, the processes of acute and chronic rejection, which involve different mechanisms, have become better understood recently and are the basis of new drugs in development.
- Drug combination strategies are being studied in clinical trials in hope that effective regimens can be created that will diminish or eliminate the need for long-term immunosuppressive therapy and its associated side effects.
- The organ transplantation antirejection drug segment is about to undergo a transition from the immunosuppressive drugs that have been mainstays until now to the immunomodulatory drugs currently in development.
- Several new immunomodulation drugs are expected to reach the market in the near future, beginning with the launch of Novartis's FTY-720, which may be launched as early as 2006-2007, depending on trial results and regulatory reviews. Bristol-Myers Squibb's LEA-29Y and Pfizer's CP-690,550, both in Phase II clinical development, could launch closer to 2010. These three key drugs, along with ongoing clinical trials focused on the elimination of immunosuppressive drugs, are expected to permanently alter the landscape of antirejection regimens by 2010.
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