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VOLUME 13 NUMBER 2 • DECEMBER 2016
DIABETES NEWS
SA JOURNAL OF DIABETES & VASCULAR DISEASE
T
he cardiovascular disease market, which
includes hypertension, dyslipidaemia
and thrombotic events, is set to grow from
$129.2 billion in 2015 to $146.4 billion by
2022, at a very modest compound annual
growth rate of 1.8%, according to business
intelligence provider GBI Research.
The company’s latest report states that
this relative stagnation can be attributed to
major product approvals coinciding with key
patent expirations. Within cardiovascular
disease there are a number of blockbuster
products that have recently gone off-patent,
and others are expected to in the coming
years, many of which belong to significant
players.
For example, the current market
leader, AstraZeneca’s Crestor (rosuvastatin),
generated around $7 billion in 2011, with
Cardiovascular disease market set to grow very slowly to $146.4 billion
by 2022, says GBI Research
revenues expected to drop sharply following
the expiration of its patent on 8 July 2016.
Total annual revenues are forecast to be
around $1.3 billion in 2022.
Thomas Jarratt, associate analyst for GBI
Research, explains: ‘Unlike AstraZeneca,
some key players will experience revenue
growth resulting from the introduction
of new products to market. In particular,
Sanofi’s Praluent (alirocumab) is expected
to help mitigate losses associated with
falling revenues of its key products Lovenox
(enoxaparin) and Plavix (clopidogrel).
‘Novartis’ heart-failure drug Entresto was
introduced to market in July 2015, and GBI
Research expects its revenues to increase
dramatically during the forecast period.
Entresto is a combination drug, which has
shown efficacy in clinical trials. Coupled with
a high cost, which amounts to over $4 500
annually per patient, the drug contributes to
a very high revenue forecast of $5.7 billion
by 2022.’
The sheer number of expirations and
approvals means the structure of the market
will shift significantly. Current market
leader AstraZeneca is set to mitigate the
damage associated with the introduction of
generic Crestor through the rising revenues
attributed to its antiplatelet drug Brilinta.
Jarratt continues: ‘the market shares of
Sanofi and Novartis are expected to increase
strongly over the forecast period, leading
to Sanofi becoming market leader, and
both brands achieving revenues in excess of
$7 billion by 2022.’
A
prospective study found that diabetic
haemodialysis patients’ sub-clinical
hyperthyroidismandeuthyroidsicksyndrome
may increase the risk of sudden cardiac-
related deaths. Dr Christiane Drechsler, of
University Hospital Würzburg in Würzburg,
Germany, and colleagues conducted a study
that included 1 000 patients undergoing
Risk of cardiac death in diabetic haemodialysis patients increased due
to thyroid problems
haemodialysis for diabetes.
Of those patients, 78.1% had
euthyroidism, 13.7% had sub-clinical
hyperthyroidism, 1.6% had sub-clinical
hypothyroidism and 5.4% had euthyroid
sick syndrome. Patients with euthyroidism
were compared with those who had sub-
clinical hyperthyroidism and euthyroid sick
syndrome with regard to which group
showed an increased short-term (within
a 12-month period) risk of sudden cardiac
death.
It showed that patients who had
euthyroidism had a 2.0-fold increased
short-term risk of sudden cardiac death, and
those who had sub-clinical hyperthyroidism
and euthyroid sick syndrome had a 2.7-fold
increase. The results showed that euthyroid
sick syndrome was associated with a three-
fold increased risk of short-term mortality,
but in the long term (two to four years) it
showed no increased risk.
The study revealed that sub-clinical
hypothyroidism was not associated with
cardiovascular events or all-cause mortality,
which indicated that thyroid disorders had
no influence on the risks of myocardial
infarction and stroke. This study led
researchers to conclude, ‘Regularly assessing
a patient’s thyroid status may help estimate
the cardiac risk of dialysis patients.’
Reference
http://www.renalandurologynews.com/thyroid-problems-up-cardiac-death-risk-in-diabetic-hd-patients/
article/348571/