Atrial Fibrillation

Pharmacor -- September 2006

  Introduction:

Atrial fibrillation (AF) is the most prevalent sustained cardiac arrhythmia and a leading cause of stroke. The substantial need for safe, convenient, and more-efficacious anticoagulants, given the toxicity and limited effectiveness of available antiarrhythmics for both acute AF treatment and AF prophylaxis, makes this indication a high-growth opportunity through 2015.

  Questions Answered in This Report:

Recent trial results have given greater prominence to a rate-control strategy for AF management. Consequently, in 2005, the combined patient share of beta blockers, calcium-channel blockers, and digoxin overtook the share captured by rhythm-controlling medication. How will the rate- versus rhythm-control debate play out over the next ten years? What impact will new antiarrhythmics have on the status of these divergent treatment approaches?

We forecast a 2010 launch of the first new oral anticoagulant in several decades, into a market clamoring for more-convenient therapies than current vitamin K antagonists for stroke prevention. What is the market potential of the new anticoagulants, and what factors will determine uptake? Will next-to-market anticoagulants be able to catch the first novel postwarfarin agent by 2015?

Some electrophysiologists in the field are touting nonpharmacological ablation procedures to become a first-line approach in place of antiarrhythmic therapy over the coming decade. What factors govern the use of ablation? How will ablation affect drug sales over the study period, and what patient segments will be affected?

  Scope:

Markets: United States, France, Germany, Italy, Spain, United Kingdom, Japan.

Primary research: 25 country-specific interviews with thought leaders.

Epidemiology: prevalence and incidence of AF.

Population segments in market forecast: new-onset AF; recurrent paroxysmal/persistent AF; permanent AF.

Emerging therapies: Phase II: 8 drugs; Phase III: 4 drugs; preregistration: 1 drug. Coverage of 5 select preclinical and Phase I products with market-disrupting potential is included.

Market forecast features: The 2005-2015 market forecast includes an analysis of drug sales and population sizes in both the acute and AF prophylaxis markets. Using Decision Resources’ proprietary patient-flow model, we examine the use of antithrombotics, rate-controlling drugs, and rhythm-controlling therapies for conversion to and maintenance of normal sinus rhythm.