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Market Spotlight: Coronary Artery Disease

  • ID: 4775146
  • Report
  • August 2020
  • Region: Global
  • 50 Pages
  • Datamonitor Healthcare
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Coronary artery disease (CAD), also called ischemic heart disease, occurs due to the narrowing of coronary arteries that supply oxygen-rich blood to the heart. A waxy substance called plaque builds up inside these arteries, leading to atherosclerosis. Plaque builds up within the coronary artery walls until the flow of oxygen-rich blood to the heart muscle is limited. This condition is also called ischemia, which may be chronic or acute. In chronic ischemia, the coronary artery narrows over time, limiting the blood flow to part of the heart muscle, while acute ischemia occurs due to a sudden rupture of plaque and formation of a blood clot. These blood clots can completely or mostly block the flow of blood through the artery, leading to acute myocardial ischemia, which further results in acute coronary syndromes. These include unstable angina, non-ST segment elevation myocardial infarction (NSTEMI), and ST-segment elevation MI (STEMI). If the oxygen-rich blood flow to the heart is blocked or reduced, heart attack or angina can occur.

Key Takeaways
  • The publisher estimates that in 2017, there were approximately 327.9 million prevalent cases of coronary artery disease worldwide, and forecasts that number to increase to 365.9 million prevalent cases by 2026.
  • Coronary artery disease has a male predominance. Globally, the publisher estimates that in 2017, 58.65% of cases aged 15 years and over were male.
  • The publisher estimates that in 2017, there were approximately 9.5 million incident cases of acute coronary syndrome worldwide, and forecasts that number to increase to 10.7 million incident cases by 2026.
  • Acute coronary syndrome has a male predominance. Globally, the publisher estimates that in 2017, 63.78% of cases aged 25 years and over were male.
  • The approved drugs in the coronary artery disease space target angiotensin converting enzyme (ACE), amyloid beta/amyloid plaques, adenosine diphosphate P2Y12 receptor, calcium channel, and coagulation factor X. The majority of marketed drugs are administered via the oral route, with one product being available in an intravenous formulation.
  • Industry-sponsored drugs in active clinical development for coronary artery disease are spread evenly across Phase I and Phase II.
  • Therapies in development for coronary artery disease focus on a variety of targets. These drugs are administered via the oral, subcutaneous, and percutaneous catheter/injection routes.
  • The only high-impact upcoming event for drugs in the coronary artery disease space is an expected CHMP opinion for Brilinta. The overall likelihood of approval of a Phase I cardiovascular disease asset is 6.8%, and the average probability a drug advances from Phase III is 54.2%. Drugs, on average, take 10.0 years from Phase I to approval in the overall cardiovascular space.
  • The distribution of clinical trials across Phase I–IV indicates that the majority of trials for coronary artery disease have been in the late phases of development, with 51% of trials in Phase III–IV, and 49% in Phase I–II.
  • The US has a substantial lead in the number of coronary artery disease clinical trials globally. Germany leads the major European markets, while China has the top spot in Asia.
  • Clinical trial activity in the coronary artery disease space is dominated by completed trials. Pfizer has the highest number of completed clinical trials for coronary artery disease, with 98 trials.
  • Pfizer leads industry sponsors with the highest overall number of clinical trials for coronary artery disease.
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Overview

Key Takeaways

Disease Background

Treatment
  • Medical management
  • Medical procedures and surgery
  • Cardiac rehabilitation
Epidemiology

Marketed Drugs

Pipeline Drugs

Recent Events and Analyst Opinion
  • Brilinta for Coronary Artery Disease (September 1, 2019)
  • HeartFlow FFRCT for Coronary Artery Disease (June 17, 2019)
  • Virtue Sirolimus-Eluting Balloon for Coronary Artery Disease (June 13, 2019)
  • MagicTouch Sirolimus DCB for Coronary Artery Disease (April 30, 2019)
  • Biomatrix NeoFlex for Coronary Artery Disease (April 2, 2019)
  • Magmaris Resorbable Magnesium Scaffold for Coronary Artery Disease (March 5, 2019)
  • Orsiro for Coronary Artery Disease (March 3, 2019)
  • Brilinta for Coronary Artery Disease (February 25, 2019)
Key Upcoming Events

Key Regulatory Events
  • Brilinta Approved to Reduce Risk of First MI, Stroke in High-Risk CAD Patients
  • Gadovist Approval Brings Contrast to Cardiac MRI
Probability of Success

Licensing and Asset Acquisition Deals
  • Deals Shaping the Medical Industry, February 2020
  • Deals Shaping the Medical Industry, July 2019
Revenue Opportunity
Clinical Trial Landscape
  • Sponsors by status
  • Sponsors by phase
  • Recent events
Bibliography
  • Prescription information
Appendix

List of Figures
Figure 1: Trends in prevalent cases of coronary artery disease, 2017–26
Figure 2: Trends in incident cases of acute coronary syndrome, 2017–26
Figure 3: Overview of pipeline drugs for coronary artery disease in the US
Figure 4: Pipeline drugs for coronary artery disease, by company
Figure 5: Pipeline drugs for coronary artery disease, by drug type
Figure 6: Pipeline drugs for coronary artery disease, by classification
Figure 7: Brilinta for Coronary Artery Disease (September 1, 2019): Phase III - THEMIS
Figure 8: Brilinta for Coronary Artery Disease (September 1, 2019): Phase III - THEMIS
Figure 9: Biomatrix NeoFlex for Coronary Artery Disease (April 2, 2019): SORT-OUT VIII (Denmark)
Figure 10: Brilinta for Coronary Artery Disease (February 25, 2019): Phase III - THEMIS
Figure 11: Key upcoming events in coronary artery disease
Figure 12: Probability of success in the coronary artery disease pipeline
Figure 13: Clinical trials in coronary artery disease
Figure 14: Top 10 drugs for clinical trials in coronary artery disease
Figure 15: Top 10 companies for clinical trials in coronary artery disease
Figure 16: Trial locations in coronary artery disease
Figure 17: Coronary artery disease trials status
Figure 18: Coronary artery disease trials sponsors, by phase

List of Tables
Table 1: Prevalent cases of coronary artery disease, 2017–26
Table 2: Prevalent cases of coronary artery disease, by gender, 2017
Table 3: Incident cases of acute coronary syndrome, 2017–26
Table 4: Incident cases of acute coronary syndrome, by gender, 2017
Table 5: Marketed drugs for coronary artery disease
Table 6: Pipeline drugs for coronary artery disease in the US
Table 7: Brilinta for Coronary Artery Disease (September 1, 2019)
Table 8: HeartFlow FFRCT for Coronary Artery Disease (June 17, 2019)
Table 9: Virtue Sirolimus-Eluting Balloon for Coronary Artery Disease (June 13, 2019)
Table 10: MagicTouch Sirolimus DCB for Coronary Artery Disease (April 30, 2019)
Table 11: Biomatrix NeoFlex for Coronary Artery Disease (April 2, 2019)
Table 12: Magmaris Resorbable Magnesium Scaffold for Coronary Artery Disease (March 5, 2019)
Table 13: Orsiro for Coronary Artery Disease (March 3, 2019)
Table 14: Brilinta for Coronary Artery Disease (February 25, 2019)
Table 15: Historical global sales, by drug ($m), 2015–19
Table 16: Forecasted global sales, by drug ($m), 2020–24
Note: Product cover images may vary from those shown
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