The liver plays a pivotal role in control of a variety of aspects of lipid metabolism. Principally, the liver synthesizes bile, ingredients of which are necessary for fat absorption in the intestine. Moreover, biliary discharge of cholesterol and phospholipids into the intestine is of key significance in body lipid homeostasis. Additionally, the liver supplies the plasma lipoproteins; it produces apoproteins that is responsible for regulating many metabolic interconversions amongst lipoprotein classes. It also regulates lipoprotein lipid ingredients such as triglycerides, cholesterol, and phospholipids. Cholestasis is a state in which the bile juice from the liver cannot flow to the duodenum (the first section of the small intestine). There are two basic types of cholestasis – obstructive type of cholestasis, and metabolic types of cholestasis. In obstructive type of cholestasis, there is a blockage in the duct system that carries the bile from the liver, whereas in the metabolic type of cholestasis there is a problem in the formation of bile in the liver. The former can occur due to gallstone or malignancy, while the latter can be genetic or may occur due to side effects of other drugs. Symptoms of cholestasis include itchiness, jaundice, pale stool, and dark urine.
One of the major cholestasis types is obstetric cholestatis. According to the Royal College of Obstetricians and Gynecologists, obstetric cholestasis affects 0.7% of pregnancies in the multiethnic populations in addition to 1.2–1.5% of pregnant women of Indian or Pakistani origin, in England. The prevalence of obstetric cholestasis is shaped by genetic as well as environmental factors. The statistics varies amongst populations worldwide. For instance, 2.4% of all pregnancies are affected in Chile. There is growing prevalence of this disease in the world, which in turn will propel the growth of the overall cholestasis treatment market.
Cholestasis Treatment Market Taxonomy
On the basis of drug class, the global cholestasis treatment market is classified into:
Cholestasis disease can affect many sides of lipid metabolism. Accumulation of toxic bile constituents in hepatocytes owing to disturbance of the bile from the liver to the gut can harm hepatocytes, which might result into damaged synthetic functionality and lessened production of enzymes concerned in the lipoprotein metabolism. Moreover, lipoprotein discharge is disturbed at some stage in cholestasis, revealed by decline in HDL levels and emergence of the abnormal lipoprotein X in the plasma. Since cholestasis can be linked to a variety of diseases, its treatment is of utmost importance. Technological advancements as well as development of efficient diagnostic tests will ensure early detection of the disease, thereby augmenting growth of the cholestasis treatment market.
Growing prevalence of obstetric cholestasis to drive growth of the overall cholestasis treatment market
According to a report published in National Center for Biotechnology Information, Intrahepatic cholestasis of pregnancy (ICP) or obstetric cholestasis is the major liver disease during pregnancy. Obstetric cholestasis is characteristically a reversible disease typically occurring in the second to third trimester. It is characterized by pruritus (severe itching of the skin) mainly in the palms and soles, prominent serum aminotransferases coupled with increased serum bile acid levels. As the number of pregnancies is likely to increase in the near future, so is the prevalence of cholestasis. Moreover, cholestasis can be hereditary in nature. There is a significant presence of chronic cholestasis in children owing to the nature of the disease. According to the National Center for Biotechnology Information, hereditary disorders of biliary atresia and intrahepatic cholestasis are the major causes of chronic liver disease amongst children. In children, they also act as the key indicators for liver transplantation. The growing population ensures increased occurrences of the disease amongst children. This in turn will drive growth of the overall cholestasis treatment market during the forecast period.
Some of the major companies operating in the cholestasis treatment market are Eli Lily and Company, Palmetto Health, Asklepion Pharmaceuticals, LLC, and Abbott Laboratories.
Major players in the market are focused on conducting clinical trials to assess their novel therapies for the treatment of cholestasis. For instance, in July 2019, Genkyotex, a biopharmaceutical company, announced positive post-hoc analysis of phase 2 trial that assessed the use of Setanaxib, a NOX-1/4 enzyme inhibitor, for the treatment of cholestatic liver disease.
Research and development related to cholestasis is expected to boost the market growth. For instance, a study presented by the Icahn School of Medicine at Mount Sinai, New York at Digestive Disease Week 2019 in San Diego identified a link between intrahepatic cholestasis of pregnancy and nonalcoholic fatty liver disease.
However, failure of therapies in the treatment of cholestasis is expected to hinder the market growth. For instance, in August 2019, a study by King’s College London published in The Lancet found that treatment with ursodeoxycholic acid does not reduce adverse perinatal outcomes in women suffering from intrahepatic cholestasis of pregnancy.