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Market Research Report

Stakeholder Opinions: Biomarkers in Rheumatology - Awaiting the next step towards personalized medicine

Published by Datamonitor
Published December, 2009 Product code 105785
Content info 106 pages
Price
US $ 3800 PDF by E-mail (Single User License)
US $ 9500 PDF by E-mail (Global Site License)


Stakeholder Opinions: Biomarkers in Rheumatology - Awaiting the next step towards personalized medicine published by Datamonitor in December, 2009. This report consists of 106 pages and the price starts from US $ 3800.

Introduction

Abstract

Introduction

The growing recognition from companies of the applied benefits from biomarkers in rheumatology has spurred commercial interest in this field. Despite the lack of major advancements, the hope remains that soon rheumatologists will be able to predict response to expensive biologic therapies and match specific treatments to patients based upon biomarker profiles.

Scope of this research

  • Classification and overview of biomarkers used in routine clinical practice across five rheumatology indications.
  • Identification of potentially promising future biomarkers and assays with insight from key opinion leaders from the seven major markets.
  • Overview of key companies actively involved in biomarker R&D, with review of latest data presented at international rheumatology conferences.
  • Assessment of the market impact of biomarkers across different facets including: diagnosis, drug development and clinical trial design, and treatment.

Research and analysis highlights

Future biomarkers will help stratify patient subgroups, aid treatment positioning and healthcare costs, but a personalized approach will ultimately lead to market fragmentation. As competition among marketed products increases, biomarkers and a shift towards market stratification is one way of ensuring new products get to market and find a niche.

Oncology leads the way with a personalized medicine approach, but unless there is a significant breakthrough, rheumatologists estimate this tailored treatment approach will be a minimum of 5 years away for chronic diseases, such as rheumatoid arthritis.

Ensuring that biomarker assays have adequate and extensive reimbursement is vital for uptake, and will involve demonstrating cost-effectiveness through clinical trials and healthcare economics. While necessary, this will be expensive, and there is also the risk that if not cost-effective, novel biomarker assays could be excluded from clinical use.

Key reasons to purchase this research

  • Understand the drivers and resistors behind biomarker identification and validation, and learn which biomarkers have the greatest future potential.
  • Learn which companies are active in the biomarker field, what approaches they are adopting and the commercialization issues they face.
  • Appreciate the potential market impact form a personalized treatment approach in rheumatology, with case studies from other fields of medicine.

Table of Contents

OVERVIEW

  • Catalyst
  • Summary

EXECUTIVE SUMMARY

  • Strategic scoping and focus
  • Datamonitor insight into the disease market
  • Related reports

OVERVIEW OF BIOMARKERS IN RHEUMATOLOGY

  • Key findings
  • Overview
    • What is a biomarker?
    • Classification of rheumatology biomarkers
    • Ideal biomarker characteristics
    • Summary of biomarkers currently used in clinical practice
  • Rheumatoid arthritis biomarkers
    • Rheumatologists use few biomarkers in current practice
    • Rationale for identifying biomarkers - towards objectivity, earlier diagnosis and treatment
    • Serum biomarkers
    • Synovial, cartilage and bone biomarkers
    • Genetic markers
    • Imaging as a biomarker for rheumatoid arthritis
  • Ankylosing spondylitis biomarkers
    • MMP-3 in the limelight again
    • Anti-TNFs show beneficial impact on biomarkers in ankylosing spondylitis
  • Psoriatic arthritis biomarkers
    • Candidate biomarkers are incorrectly borrowed from rheumatoid arthritis
    • Certain biomarkers correlate with disease activity
    • MMP-3 may predict response to anti-TNF therapy in psoriatic arthritis
  • Osteoarthritis biomarkers
    • Physicians ranked biomarkers as the lowest priority unmet need in osteoarthritis
    • Summary of osteoarthritis biomarkers
  • Systemic lupus erythematosus biomarkers
    • Biomarkers are a major unmet need in this disease
    • Renewed enthusiasm for identifying SLE biomarkers
    • Potential biomarkers exist, but further validation is required
    • Companies are looking specifically at SLE biomarkers

KEY COMPANIES INVOLVED IN BIOMARKER R&D

  • Key findings
  • Huge commercial interest in the biomarker field
    • There is a clear demand for new biomarkers
  • Commercialization issues
    • Collaboration is vital for commercializing novel rheumatology biomarkers
    • Biomarker patents - an area of uncertainty
    • Differences between US and EU regulatory pathway add to complexity of the biomarker area
  • Companies
    • Overview of companies
    • Axis-Shield
    • Abbott
    • Centocor Ortho Biotech and Schering-Plough
    • Crescendo Bioscience
    • Cypress Bioscience
    • Euro-Diagnostica
    • GeneNews
    • GlaxoSmithKline
    • HuBit Genomix
    • Nordic Bioscience
    • Novartis
    • Pfizer
    • Roche/Genentech
    • Sense Proteomic (now part of Oxford Gene Technology)
    • SQI Therapeutics
    • 23andMe

MARKET IMPACT AND CASE STUDIES

  • Key findings
  • Drivers and resistors of biomarkers development and personalized medicine
  • Impact of biomarkers on diagnosis
    • Earlier identification and treatment of patients at risk of severe disease
  • Impact of biomarkers on drug development
    • Reducing the time and cost of drug development
    • Biomarkers and clinical trial design in rheumatology
  • Impact of biomarkers on treatment
    • Predicting response to therapy
    • Towards a personalized treatment approach in rheumatology
    • Issues with market segmentation fragmentation
  • Case studies
    • Oncology - what rheumatology can learn from this disease area
    • Pharmacogenomic biomarkers of susceptibility to adverse drug reactions
    • Warfarin - optimizing the dosing regimen using genomic biomarkers

BIBLIOGRAPHY

  • Journal papers and conference abstracts
  • Websites
  • Datamonitor Reports

APPENDIX

  • Contributing experts

TABLES

  • Table: Markers of degradation of cartilage and bone in rheumatoid arthritis
  • Table: Genetic markers in rheumatoid arthritis, 2009
  • Table: Serum biomarkers for disease activity in psoriatic arthritis, 2008
  • Table: Osteoarthritis biomarkers of bone, cartilage and synovial turnover and how they relate to the BIPED classification, 2007
  • Table: Potential biomarkers for systemic lupus erythematosus, shown by category, 2009
  • Table: Potential urinary biomarkers in lupus nephritis, 2009
  • Table: Patent information for well known rheumatoid diagnostic tests, 2009
  • Table: Overview of companies involved in rheumatology biomarkers, 2009
  • Table: Centocor Ortho Biotech publications for rheumatology biomarkers, 2007 - 09
  • Table: Efficacy difference between rituximab and placebo treated patients at week 24 in the SERENE trial, 2009
  • Table: Diagnosis rates, time from symptom onset to physician presentation and time to receipt of first DMARD for rheumatoid arthritis across the seven major markets, 2006
  • Table: Advances in genomic predictors of response, 2009

FIGURES

  • Figure: Classification of biomarkers in rheumatology, 2009
  • Figure: Generalized overview of currently validated markers in each of the major rheumatology indications, 2009
  • Figure: Relation of disease activity, joint damage, disability and biomarkers reflecting the three elements of the natural history of rheumatoid arthritis
  • Figure: Impact of disease-modifying antirheumatic drugs on rheumatoid arthritis progression
  • Figure: A 2-year blinded study comparing methotrexate and infliximab with methotrexate alone in aggressive early rheumatoid arthritis on joint damage progression using ultrasonography, radiography and serum biomarkers, 2009
  • Figure: Design of study identifying biomarkers associated with response to anti-TNF therapy in patients with psoriatic arthritis, 2009
  • Figure: Priority ranking allocated by physicians to unmet needs in the treatment of osteoarthritis, 2009
  • Figure: Priority rating allocated by rheumatologists to challenges in systemic lupus erythematosus management, 2008
  • Figure: Division of companies in the rheumatology biomarker field
  • Figure: The US and EU regulatory pathways for market authorization of biomarker-based assays/in vitro diagnostics, 2009
  • Figure: Anti-CCP product timeline for Axis-Shield, 2001 - 09
  • Figure: Sales of Axis-Shield' s non-AxSYM xtra anti-CCP laboratory diagnostic tests in the EU, 2005 - 08
  • Figure: Pilot matrix risk model quantifying the probability of patients who will experience rapid radiographic progression, 2009
  • Figure: BeSt trial matrix models in recent-onset rheumatoid arthritis patients, 2009
  • Figure: Nordic Bioscience R&D operates a number of programs, including biomarker research, across a number of therapeutic areas
  • Figure: Drivers and resistors of biomarker development and personalized medicine in rheumatology, 2009
  • Figure: Investment required for the successful launch of a single drug and areas where use of biomarkers could reduce costs
  • Figure: Integration of biomarkers into the various stages of drug development
  • Figure: Personalized medicine versus translational medicine drug-development strategies
  • Figure: Impact on market share from the adoption of personalized medicine in rheumatology
  • Figure: Patient care path for rheumatoid arthritis showing points of impact from biomarkers, 2009
  • Figure: Impact of biomarkers on current rheumatoid arthritis treatment recommendations
  • Figure: FDA' s biomarker testing requirements, 2009
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