Wolters Kluwer Pharma Solutions: inThought Report Says New Wave of Cardiology Drugs to be Big Boon
According to the report, one of the most promising areas is a new wave of anticoagulants destined to change the course of therapy for stroke and other clot patients. Key front-runners include Pfizer and Bristol’s Eliquis, Johnson & Johnson’s Xarelto, Boehringer’s Pradaxa, and Daiichi’s edoxaban. Although at varying stages of development, inThought says clinical trial data puts these agents collectively on a track to replace warfarin, the current oral anticoagulant standard-bearer.
“We’ve been looking for a replacement for warfarin for 25 years and although there were many notable candidates that have tried and failed, today we are seeing the first real breakthroughs in treating clots and that can reduce bleeding and other adversities,” said Leon Henderson, Senior Analyst, inThought. “Warfarin requires constant blood monitoring and strict diet guidelines. The new anticoagulants minimize these issues and are attractive to both cardiologists and patients. Our report provides a roadmap for which new oral anticoagulant will be preferred in various clinical scenarios.”
According to Dr. Henderson, it is becoming clear that we have to tease out the different indications. For instance, for stroke prevention in atrial fibrillation (SPAF), clinical data indicate Eliquis may be most often preferred. However, for ischemic stroke risk reduction in those least likely to bleed, Pradaxa may frequently be favored. For acute coronary syndromes including heart attack, Eliquis has not fared as well as Xarelto. Lastly, edoxaban is in phase III trials, with Daiichi surveying the market for its best point of entry. The bottom line, there is room for all four of these drugs and possibly others.
HDL-Raisers Raise the Bar
After being on the backburner after a failed attempt by Pfizer five years ago, HDL-raising is back in the spotlight, according to inThought. Heart attack prevention is always an important area of interest, and a growing body of evidence suggests that that raising HDL medically can help prevent heart attacks and other coronary events. The inThought report examines three promising new drugs in this area: anacetrapib from Merck, dalcetrapib from Roche, and evacetrapib from Lilly. All three are emerging from phase II trials looking like they lower HDL without increasing atherosclerosis or coronary plaque.
“There was a lot more skepticism in the HDL arena prior to the mid-phase trials of Merck and Roche,” said Dr. Henderson. “Anacetrapib was first in this class to show it could raise HDL without associated increase in plaque and, even more so, without some of the other markers that would predict increased atherosclerosis in the coronary arteries.”
Roche’s dalcetrapib, according to Dr. Henderson, appears to have more HDL-raising ability than Merck’s anacetrapib, but whether that is of clinical benefit, we will just have to wait for the next set of trial data. The most recent data, presented at the AHA conference in Orlando, Fla., in November, suggest Lilly’s evacetrapib also was associated with raising HDL while reducing coronary plaque — setting up a competitive three-way race.
PCSK9 Gains Momentum
In addition to raising good cholesterol (HDL), the search is still on for newer, better LDL-cholesterol-lowering products. The most well known brand in this class, Lipitor, went off patent in November and, according to the inThought report, cardiologists are now watching PCSK9 modulators, a new approach, as a potential way to increase the efficacy of current drugs.
“All of the experts have been saying that the most important new drug class in dyslipidemia is a new group called PCSK9 inhibitors, led by a highly promising LDL-lowering agent from Sanofi and Regeneron,” added Dr. Henderson. “Right behind those, we’re watching the most recent Amgen study that is really going to raise the profile of this class over time. And, Novartis, Alnylam, Tekmira, Santaris, Isis, and Bristol are not too far behind.”
Led by a team of industry veterans with extensive sell-side research experience, inThought delivers actionable market research reports read by pharmaceutical and healthcare professionals worldwide. The new report, entitled “Innovative Medicine Shaping the Cardiology Market: Reviewing AHA and Looking Ahead,” is available for purchase on the inThought website at www.in-thought.com. For additional information, visit the Wolters Kluwer Pharma Solutions homepage at www.wolterskluwerpharma.com.
About Wolters Kluwer Pharma Solutions
Wolters Kluwer Pharma Solutions, Inc. (Phoenix, AZ) is a leading provider of information and analytics to the pharmaceutical, biotech and financial industries. The company’s brands include Source®, ProMetis™ and inThought™. A longstanding provider of market data and healthcare analytics, Source offers a unique set of comprehensive patient and physician-level prescribing and usage data. ProMetis provides a three-dimensional market view of prescriber, patient and payer activity in a breakthrough, integrated platform. Led by a team of industry veterans with extensive sell-side research experience, inThought delivers actionable market research reports read by pharmaceutical and healthcare professionals worldwide. For more information, visit www.wolterskluwerpharma.com and www.in-thought.com.
Wolters Kluwer Pharma Solutions is a part of Wolters Kluwer, a market-leading global information services company with 2010 annual revenues of €3.6 billion ($4.7 billion).