Stakeholder Opinions: Respiratory Syncytial Virus (RSV)

A market yet to reach its full potential

Publication Date	December 2006
Publisher	Datamonitor
Product Type	Report
Pages	150
ISBN Number	not applicable
Product Code	DAT03922

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Summary

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

Content

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 $700750 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
- Disclaimer