Respiratory Syncytial Virus (RSV) - A market yet to reach its full potential
Scope
Report Highlights
Reasons to Purchase
Table of Contents
- ABOUT DATAMONITOR HEALTHCARE - page 2
- About the Infectious Diseases and Respiratory (ID&R) analysis team - page 2
- CHAPTER 1 EXECUTIVE SUMMARY - page 3
- Scope of the report - page 3
- Contributing experts - page 3
- Datamonitor insight into the respiratory syncytial virus (RSV) market - page 4
- CHAPTER 2 DISEASE BACKGROUND - page 11
- Etiology of the RSV virus - page 11
- RSV is easily transmitted - page 15
- Immune response does not sufficiently protect from further infection - page 16
- Symptoms and classification - page 17
- Groups at risk of severe disease caused by RSV infection - page 19
- Young children and premature infants - page 29
- Elderly - page 35
- People with underlying cardiac or pulmonary disease - page 37
- Immunocompromised patients - page 43
- Nosocomial RSV infections - page 44
- RSV reinfection - page 45
- The seasonality of RSV - page 46
- Mortality is low in most risk groups - page 49
- Hospitalization expenses make RSV infections costly - page 50
- Etiology of the RSV virus - page 11
- CHAPTER 3 DIAGNOSIS - page 52
- Viral culture is the current gold standard - page 54
- Polymerase chain reaction may become new gold standard - page 54
- Antigen detection assays are fast but lack sensitivity - page 57
- Bronchiolitis guidelines - page 58
- CHAPTER 4 CURRENT TREATMENT AND PREVENTION OPTIONS - page 61
- Synagis has monopoly in RSV infection prophylaxis - page 63
- The Phase III IMpact trial showed efficacy and safety - page 67
- Separate trial in children with congenital heart disease leads to indication expansion - page 68
- Synagis's cost-effectiveness is doubtful - page 71
- Virazole's reputation is damaged by negative trials - page 73
- Lack of evidence for use of pharmacological symptom treatment - page 76
- Beta2-agonists - page 77
- Ipratropium bromide - page 79
- Epinephrine - page 79
- Corticosteroids - page 80
- Non-pharmacological symptom treatments show some improvement in subpopulations - page 81
- Bronchiolitis guidelines - page 82
- Prescribing trends - page 84
- Synagis has monopoly in RSV infection prophylaxis - page 63
- CHAPTER 5 FUTURE TRENDS - page 88
- Most important unmet need is the lack of RSV treatment and vaccines - page 89
- Future trends in treatment - page 91
- The antivirals class is the most advanced (Phase II) - page 93
- RNA interference (RNAi) as antiviral is a promising approach - page 95
- Antisense drugs not in clinical trials yet - page 97
- An RSV treatment used in the hospital could have peak sales of $700-750 million - page 98
- An RSV treatment used in the community could have peak sales of more than $1 billion - page 100
- Future trends in prophylaxis - page 102
- Future trends in vaccines - page 104
- Types of vaccines in development for RSV - page 107
- Strategies of a vaccination program - page 111
- MedImmune also dominates limited RSV vaccine development - page 116
- APPENDIX A BIBLIOGRAPHY - page 118
- Press releases - page 144
- APPENDIX B COMMERICALLY AVAILABLE ANTIGEN DETECTION ASSAYS - page 146
- Disclaimer - page 150
- List of Tables
- Table 1: RSV prevalence in the seven major markets, 2006 - page 21
- Table 2: RSV prevalence in the US, 2006 - page 22
- Table 3: RSV prevalence in Japan, 2006 - page 23
- Table 4: RSV prevalence in France, 2006 - page 24
- Table 5: RSV prevalence in Germany, 2006 - page 25
- Table 6: RSV prevalence in Italy, 2006 - page 26
- Table 7: RSV prevalence in Spain, 2006 - page 27
- Table 8: RSV prevalence in the UK, 2006 - page 28
- Table 9: Children under four years of age with RSV infection, 2006 - page 32
- Table 10: RSV infection in premature babies in the seven major markets, 2006 - page 34
- Table 11: Elderly infected with RSV virus, 2006 and 2015 - page 37
- Table 12: Group of CHF patients in class II or higher, at risk of RSV infection, 2006 - page 40
- Table 13: High-risk population with RSV infection including CHF, asthma and COPD patients, 2006 - page 41
- Table 14: Bone marrow transplant recipients with RSV infection, 2006 - page 44
- Table 15: Summary of Synagis trials - page 70
- Table 16: Cost-benefit of Synagis - page 71
- Table 17: Institutional variation of medical management of bronchiolitis caused by RSV - page 85
- Table 18: Percentage of respondents applying different treatment options in infants hospitalized with acute bronchiolitis - page 87
- Table 19: Non serious adverse events of RSV-604 in Phase I trial - page 94
- Table 20: RSV hospitalizations in different high risk groups in the seven major markets - page 99
- List of Figures
- Figure 1: Respiratory syncytial viral structure - page 13
- Figure 2: A schematic representation of RSV infection of the respiratory epithelium - page 15
- Figure 3: RSV disease severity over four consecutive seasons - page 19
- Figure 4: RSV is a major pediatric pathogen - page 30
- Figure 5: Example of definition of high-risk chronic heart failure patients in the US, 2005 - page 39
- Figure 6: Group of adults over 21 years of age with or without underlying disease that are annually hospitalized due to an RSV infection - page 42
- Figure 7: Several factors increase the likelihood of nosocomial infection - page 45
- Figure 8: Positive RSV tests in the US (%), July 2004-October 2006 - page 46
- Figure 9: Laboratory reports to CDSC* of infections due to RSV, England and Wales, by date of report 1990-2006 (4 weekly) - page 48
- Figure 10: The process of polymerase chain reaction (PCR) - page 55
- Figure 11: Overview of several antigen detection assays commercially available - page 58
- Figure 12: RSV product sales in the seven major markets by year, Q3 2001-Q2 2006 (RespiGam only US) - page 62
- Figure 13: Synagis is currently the only marketed RSV prophylaxis - page 64
- Figure 14: Synagis sales in the seven major markets by quarter, Q3 2001-Q2 2006 - page 66
- Figure 15: Small Particle Aerosol Generator Model-2 (SPAG-2) - page 74
- Figure 16: Virazole sales in the seven major markets by quarter, Q3 2001-Q2 2006 - page 76
- Figure 17: The American Academy of Pediatrics (AAP) bronchiolitis guidelines - page 83
- Figure 18: Proportion of clinical episodes in which inhaled and systemic treatment approaches were used - page 86
- Figure 19: Future trends in RSV treatment, prophylaxis and vaccines - page 89
- Figure 20: Overview of companies involved in development of RSV treatment, 2006 - page 92
- Figure 21: Percentage of RSV hospitalizations in pivotal Numax trial - page 103
- Figure 22: Size of very high risk vaccine target populations across the seven major markets, 2006 - page 113
- Figure 23: Size of pediatric vaccine target populations across the seven major markets, birth cohort and catch-up pool, 2006 - page 115
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