Market Report Source

Overview

Introduction
Datamonitor estimates that there are nearly 86 million Metabolic Syndrome patients in the six major markets. Although the patient pool in need of treatment for Metabolic Syndrome is large, the lack of an approved indication for Metabolic Syndrome, the lack of a consensus definition and the aversion of physicians to pharmacotherapy limit the size of the Metabolic Syndrome market, considerably

Scope
Determination of the prevalence of Metabolic Syndrome and its component conditions

Evaluation of physician awareness of Metabolic Syndrome and its importance, and of physician perceptions of treatment options for the condition

Assessment of the potential of existing drug classes and developmental compounds in the treatment of Metabolic Syndrome

Understanding of the critical issues affecting the Metabolic Syndrome market

Report Highlights
The lack of a consensus definition for Metabolic Syndrome is complicating the diagnosis and management of patients.

Lifestyle intervention may not be the most rational approach when treating Metabolic Syndrome patients.

The significant patient potential and unmet need characteristic to the Metabolic Syndrome market are counterbalanced by a significant number of challenges.

Reasons to Purchase
Target physicians more effectively, through an understanding of prescribing behavior and its influences

Assess the impact that the different definitions of the condition have in the management of Metabolic Syndrome

Recognize lucrative target populations, in terms of unmet need and patient potential, in order to successfully position developmental products

Table of Contents

TABLE OF CONTENTS

CHAPTER 1 EXECUTIVE SUMMARY

Scope of the analysis

Datamonitor insight into the Metabolic Syndrome market

The lack of a consensus definition for Metabolic Syndrome is complicating the diagnosis and management of patients.

The prevalence of Metabolic Syndrome is driven by the obesity epidemic. However, its great diversity makes it hard to identify treatment targets.

Lifestyle intervention may not be the most rational approach when treating Metabolic Syndrome patients.

The significant patient potential and unmet need characteristic to the Metabolic Syndrome market are counterbalanced by a significant number of challenges.

CHAPTER 2 INTRODUCTION AND SCOPE

Coverage of the Stakeholder Insight Survey

CHAPTER 3 COUNTRY TREATMENT TREES

Introduction to the treatment trees

US

France

Germany

Italy

Spain

UK

CHAPTER 4 DEFINITION OF METABOLIC SYNDROME

Background

Pre-diabetic population

Metabolic Syndrome

Confusion over syndrome name

Disease definition

Pathogenesis

Clinical criteria for diagnosis

Controversy surrounding definitions

Metabolic Syndrome as a marker for cardiovascular disease

Progression of Metabolic Syndrome to disease/events

Insulin resistance and its associated conditions

Insulin resistance and obesity

Insulin resistance and aging

Insulin resistance and dyslipidemia

Insulin resistance and hypertension

Insulin resistance and thrombosis

Insulin resistance and advanced glycation end products

Insulin resistance and the hepatic insulin-sensitizing substance effect

Detection, screening and diagnosis – a topic of debate

Diagnosis of insulin resistance

IGT versus IFG

Impact on drug development

Who should be screened?

Screening tests

Other considerations

CHAPTER 5 EPIDEMIOLOGY OF METABOLIC SYNDROME

Disease definition and classification

Prevalence of Metabolic Syndrome

Metabolic Syndrome prevalence methodology

US

France

Germany

Italy

Spain

UK

Impaired fasting glucose prevalence

Impaired fasting glucose prevalence methodology

Dyslipidemia prevalence

Hypercholesterolemia prevalence methodology

US

France

Germany

Italy

Spain

UK

Hypertension prevalence

Hypertension prevalence methodology

US

France

Germany

Italy

Spain

UK

Obesity prevalence

Obesity forecasts

Obesity prevalence methodology

US

France

Germany

Italy

Spain

UK

Forecast methodology

Prevalence of obesity in juveniles

CHAPTER 6 SEGMENTATION OF METABOLIC SYNDROME PATIENTS

Breakdown by demographic characteristics

Breakdown by risk factor

High risk patient profile

Treatment guidelines

Importance of treating Metabolic Syndrome

CHAPTER 7 LIFESTYLE MANAGEMENT VERSUS PHARMACOLOGICAL TREATMENT

Management of Metabolic Syndrome

Lifestyle Management

Lifestyle management and clinical practice.

Delayed diagnosis of Metabolic Syndrome

Therapeutic Lifestyle Changes (TLC)

CHAPTER 8 PRESCRIBING TRENDS

Current role for pharmacological treatment

Approaches to the pharmacological treatment of Metabolic Syndrome

Overall prescribing trends

Obesity

Xenical

The XENDOS study shows orlistat reduces risk of type 2 diabetes

The FDA approves the use of orlistat in adolescents

The European Commission approves label extension

Meridia

Behavior therapy and sibutramine for the treatment of adolescent obesity

STORM trial shows weight-maintenance success after weight loss is positively influenced by sibutramine and leisure-time activity.

Sibutramine has a positive effect on clinical and metabolic parameters in obese patients with polycystic ovary syndrome (PCOS)

Sibutramine effective in the treatment of binge-eating disorder

No benefits shown in health-related quality of life study in sibutramine-treated obese patients with type 2 diabetes

SCOUT study

Acomplia

Clinical trial data

Prescription trends

Dyslipidemia

Statins

ASCOT

AVALON

Ezetimibe

Combination therapies

Vytorin

Caduet

Fibrates

Nicotinic acid derivatives

Prescription trends

Hypertension

ARBs

ACEIs

Beta-blockers (BBs)

Calcium-channel blockers (CCBs)

Diuretics

Prescription trends

Diabetes

Biguanides

Sulfonylureas

Thiazolidinediones

Alpha glucosidase inhibitors

Insulin

Prandial Glucose Regulators

Prescription Trends

Pill Burden

Metabolic Syndrome and disease prevention

Insulin Resistance

Obesity

Awareness of developmental classes of compounds

CHAPTER 9 CRITICAL ISSUES AFFECTING METABOLIC SYNDROME

Unmet needs – Challenges

Clinical unmet needs – challenges

Consensus definition

Efficacy goals not met by current treatment

Need to curb the epidemic rise in the prevalence of Metabolic Syndrome.

Avoiding compensatory feedback mechanisms

Need to take advantage of synergies between drugs, diet, exercise and behavior

If possible, address underlying cause(s) to the Metabolic Syndrome

Commercial unmet needs-challenges

Metabolic Syndrome not approved as indication

Prevention of disease in “healthy” subjects associated with higher demands on side effects and tolerability

Safety

Outcome studies will be required to demonstrate benefits of CVD and diabetes prevention

Clinical trial issues

APPENDIX A BIBLIOGRAPHY

References

APPENDIX B PRIMARY RESEARCH

Physician research methodology

Physician sample breakdown

US

France

Germany

Italy

Spain

UK

Questionnaire

1. Patient Segmentation and Diagnosis

2. Treatment of Metabolic Syndrome

3. Future developments

4. Patient outcomes

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