COPD併存疾患の治療：全身性抗炎症薬の市場機会

Abstract

Introduction

Research data on COPD increasingly point to systemic infl ammation as the cause of many of the severe comorbidities associated with the disease. However, agents under study for COPD continue to focus only on the local infl ammation caused by the disease. Signifi cant opportunity exists for agents that can reduce the infl ammation both in the lungs and throughout the system. Given that inhaler drugs will not be displaced as the primary treatment for the disease, is there a drug on the market for another indication that will address the systemic comorbidities associated with COPD? Should any existing therapies be able to show clear clinical benefi t on systemic infl ammation, such an agent would gain a useful competitive edge in the COPD market.

Get the Answers You Need to Shape Your Strategy

• COPD is a progressive infl ammatory disease affecting the respiratory tract and the lungs. What comorbidities are associated with COPD? What roles do local and systemic infl ammation play in this disease? What is the status of research on the connection between systemic infl ammation and pulmonary function?
• Researchers are beginning to investigate the potential of systemic agents in the treatment of COPD. What are some of the most promising drug classes being studied? Will these agents have an effect on the localized symptoms and the severe comorbidities?
• See the appendix in this report for a discussion on the current treatments for localized COPD. What are the most effective treatments? What new therapies need to be considered?

Scope

• The role of inflammation in the comorbidities in COPD: therapies are needed to address the multiple facets of the disease; established agent for another indication may be aimed at COPD.
• Risk factors: cigarette smoking; particulate dust; impaired lung development; age; nutritional and socioeconomic factors.
• Comorbidities: chronic cardiovascular diseases; osteoporosis; type 2 diabetes; cachexia.
• Treatments most likely to address systemic infl ammation: TNF-α inhibitors; PPAR-gamma agonists; statins; PDE-5 inhibitors.

Table of Contents

• Executive Summary
  • Strategic Considerations
  • Stakeholder Implications
• Introduction
• Understanding the Mechanisms of COPD
  • Risk Factors for COPD
  • Pathophysiology of COPD
    • Small Airway Disease
    • Emphysema
  • Role of Systemic Infl ammation in COPD
• Comorbidities Associated with COPD Caused by Systemic Infl ammation
  • Cardiovascular Complications: Atherosclerosis and Pulmonary Arterial Hypertension
    • Atherosclerosis
    • Pulmonary Arterial Hypertension
  • Osteoporosis
  • Type 2 Diabetes
  • Cachexia
• Drug Classes with Possible Use in Treating the Systemic and Localized Infl ammation of COPD
  • TNF-α Inhibitors
  • PPAR-Gamma Agonists
  • Statins
  • PDE Inhibitors
• Assessing the Unanswered Questions About Treating Systemic Infl ammation in COPD
• Appendix:Current Treatments for Localized COPD
  • Short-Acting Beta2 Agonists
  • Long-Acting Beta2 Agonists
  • Muscarinic Antagonists
  • Inhaled Corticosteroids
  • Beta2 Agonist/Muscarinic Antagonist Combinations
  • Long-Acting Beta2 Agonist/Inhaled Corticosteroid Combinations
  • Methylxanthines

Tables:

• 1. Sales of Leading Agents to Treat COPD, 2006
• 2. Risk Factors Linked to COPD
• 3. Infl ammatory Molecules Involved in COPD
• 4. Existing and Emerging TNF-α Inhibitors, 2008
• 5. Existing and Emerging PPAR-Gamma Agonists, 2008
• 6. Approved Statins, 2008
• 7. Approved and Emerging PDE 4 and 5 Inhibitors, 2008

Figures:

• 1. Prevalent Cases of COPD in the United States, Europe, and Japan, 2006 and 2011
• 2. Comorbidities Associated with COPD