Market Report Source

Overview

Introduction
RSV mostly causes upper respiratory tract infections (URTI), resulting in the common cold. However, in certain risk groups, RSV can cause more severe lower respiratory tract infections (LRTI) leading to bronchiolitis. These risk groups include elderly people, patients with underlying pulmonary or cardiac disease, premature infants, children under four years old and immunocompromised patients.

Scope
Discusses disease background, providing insight in RSV epidemiology, etiology and symptoms
Gives a breakdown of RSV (hospitalization) prevalence in the seven major markets
Examines current diagnosis and treatment trends, providing physicians’ opinions
Examines the RSV pipeline by type treatment, prophylaxis and vaccines, including a short discussion of each pipeline product

Highlights
Some physicians do not value the importance of a correct RSV diagnosis, since there is no effective treatment available. Furthermore, the American Academy of Pediatrics does not recommend routine testing for RSV in bronchiolitis. However, there are reasons why proper diagnosis should be considered, and there is a range of tests available for that.

The RSV market is currently dominated by MedImmune’s Synagis, a prophylactic monoclonal antibody. As RespiGam’s successor, Synagis was first launched in 1998 and now has sales of around $750 million per RSV season. Due to its high costs though, Synagis is only prescribed to a very limited group of individuals.

Although the most important unmet need in RSV is an effective treatment or vaccine, many companies have discontinued their developments in this field. Only two companies have an RSV treatment in clinical development (Novartis/Arrow Therapeutics and Alnylam) and MedImmune dominates the limited vaccine development.

Reasons to Purchase
Gain insight into the issues of current diagnosis and treatment for RSV through key opinion leader comments
Review the unmet needs and the clinical and commercial factors driving new product decisions
Identify the opportunities and threats presented by the RSV pipeline and predict the future shape of the market

Table of Contents

CHAPTER 1 EXECUTIVE SUMMARY

Scope of the report

Contributing experts

Datamonitor insight into the respiratory syncytial virus (RSV) market

CHAPTER 2 DISEASE BACKGROUND

Etiology of the RSV virus

RSV is easily transmitted

Immune response does not sufficiently protect from further infection

Symptoms and classification

Groups at risk of severe disease caused by RSV infection

Young children and premature infants

Elderly

People with underlying cardiac or pulmonary disease

Immunocompromised patients

Nosocomial RSV infections

RSV reinfection

The seasonality of RSV

Mortality is low in most risk groups

Hospitalization expenses make RSV infections costly

CHAPTER 3 DIAGNOSIS

Viral culture is the current gold standard

Polymerase chain reaction may become new gold standard

Antigen detection assays are fast but lack sensitivity

Bronchiolitis guidelines

CHAPTER 4 CURRENT TREATMENT AND PREVENTION OPTIONS

Synagis has monopoly in RSV infection prophylaxis

The Phase III IMpact trial showed efficacy and safety

Separate trial in children with congenital heart disease leads to indication expansion

Synagis’s cost-effectiveness is doubtful

Virazole’s reputation is damaged by negative trials

Lack of evidence for use of pharmacological symptom treatment

Beta2-agonists

Ipratropium bromide

Epinephrine

Corticosteroids

Non-pharmacological symptom treatments show some improvement in subpopulations

Bronchiolitis guidelines

Prescribing trends

CHAPTER 5 FUTURE TRENDS

Most important unmet need is the lack of RSV treatment and vaccines

Future trends in treatment

The antivirals class is the most advanced (Phase II)

RNA interference (RNAi) as antiviral is a promising approach

Antisense drugs not in clinical trials yet

An RSV treatment used in the hospital could have peak sales of $700–750 million

An RSV treatment used in the community could have peak sales of more than $1 billion

Future trends in prophylaxis

Future trends in vaccines

Types of vaccines in development for RSV

Strategies of a vaccination program

MedImmune also dominates limited RSV vaccine development

APPENDIX A BIBLIOGRAPHY

Press releases

APPENDIX B COMMERICALLY AVAILABLE ANTIGEN DETECTION ASSAYS

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