Pulmonary hypertension or PH is a condition in which the blood pressure rises in the pulmonary artery, vein, or capillaries (collectively known as lung vasculature), which might lead to shortness of breath, fainting, leg swelling, and dizziness, among others. Pulmonary hypertension may be a relentless disease with a noticeable reduction in exercise tolerance. Pulmonary arterial hypertension or PAH indicates that the patient has high blood pressure in arteries that carry blood from the heart to the lungs. With PAH, the arteries in the lungs become thin or get blocked resulting into irregular blood flow. Since the flow of blood is hindered, it becomes hard for the blood to flow evenly thereby, increasing the blood pressure in the patient. In layman terms, it means that the heart works harder to pump blood. It may lead to weakening of the heart muscles after a certain period of time. Ultimately, pulmonary arterial hypertension may cause heart failure.
Based on the reports gathered from a variety of sources, including CDC (Centers for Disease Control and Prevention) and WHO (World Health Organization), the global prevalence of pulmonary arterial hypertension is projected to be 100,000 – 200,000, that is about 15 - 50 patients per million of the population. Even though, the treatment available for pulmonary arterial hypertension is rather limited, various treatment options are available to decrease symptoms, slow down disease progression, and improve the quality of life. Endothelin receptor antagonists or ERAs, phosphodiesterase-5 (PDE-5) inhibitors and Prostacyclin and prostacyclin analogs are some of the widely prescribed drug classes used for treatment of the disease. Lately, a new drug class known as the soluble guanylate cyclase or sGC stimulators has been recognized to be effective in treating people with PAH.
On the contrary, the expiry of patents of major pulmonary arterial hypertension drugs such as Letairis, Tracleer, Tyvaso, and Adcirca is projected to pose a challenge for the growth of the market, as the generic versions of these drugs will be sold at 70% to 80% lower prices than that of the present branded drugs. Various breakthrough therapies for treatment of pulmonary arterial hypertension is projected to be a growth factor for the PAH treatment drug manufacturers, since the available drugs for the same are not sufficient to meet the patient’s needs. These factors will fuel growth of the PAH market and increase the demand for PAH treatment drugs.
Pulmonary Arterial Hypertension (PAH) Market Taxonomy
On the basis of drug class, the global pulmonary arterial hypertension market is classified into:
On the basis of application, the global pulmonary arterial hypertension market is classified into:
ERAs was the largest segment in the current scenario. However, the prostacyclin and prostacyclin analogs segment is projected to expand at the highest CAGR over the forecast period, owing to the authorization of Orenitram (treprostinil extended release tablet) in 2013 and the anticipated endorsement of Uptravi (selexipag) in 2016.
Growing prevalence of cardiac diseases to drive growth of the overall pulmonary arterial hypertension (PAH) market
Owing to the sedentary lifestyles, growing consumption of fast food, and lack of exercise, the global numbers for the patients with cardiac diseases is expected to rise substantially over the forecast period thereby, increasing the susceptibility of pulmonary arterial hypertension among the global population. This would propel the overall growth of the PAH market in the near future.
North America accounted for the largest market share of the global PAH treatment market, followed by Europe. These regional market are projected to witness considerable growth in the forecast period, owing to the freshly approved PAH medicines in the market and high prevalence of heart diseases.
Some of the major companies operating in the pulmonary arterial hypertension (PAH) market in the current scenario are Actelion Pharmaceuticals, Ltd., Gilead Sciences, Inc., United Therapeutics Corporation, Bayer HealthCare, Pfizer, Inc., Novartis International AG and GlaxoSmithKline plc.
Major institutes are focused on conducting clinical trials related to pulmonary arterial hypertension. For instance, in August 2019, researchers from the Boston University and UT Southwestern Medical Center, William P. Clements Jr. University Hospital conducted Phase 2 study to assess the efficacy, safety, and tolerability of immediate-release orally administered ralinepag, a selective, non-prostanoid prostacyclin receptor (IP) agonist for the treatment of pulmonary arterial hypertension (PAH). The research published in the European Respiratory Journal found that ralinepag reduces pulmonary vascular resistance in pulmonary arterial hypertension.
Similarly, in August 2019, Altavant Sciences, a clinical-stage biopharmaceutical company, announced that it has dosed the first patient in a Phase 2a study to assess the efficacy of rodatristat ethyl, a tryptophan hydroxylase inhibitor designed to reduce the body's peripheral production of serotonin, in patients with pulmonary arterial hypertension (PAH).
In August 2019, researchers from University of South China and other Chinese institutes determined the functions of Eukaryotic initiation factor 2α (eIF2α) and autophagy in the vascular remodeling of the monocrotaline-induced PAH rats and to clarified the correlation between eIF2α and autophagy. In the research published in Dovepress, the team found that eIF2α promotes the proliferation of pulmonary artery smooth muscle cells and vascular remodeling in monocrotaline-induced PAH rats through accelerating autophagy pathway.
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