Acute respiratory distress syndrome (ARDS) is a serious lung condition that is associated with a substantial rate of morbidity and mortality. It is a common cause of respiratory failure in infants and critically ill patients. Characterized by the acute onset of noncardiogenic pulmonary oedema, hypoxaemia, ARDS makes the patients seek the need for mechanical ventilation. The causes of ARDS range from pulmonary (such as pneumonia, aspiration) to non-pulmonary (like sepsis, pancreatitis, and trauma) abuses, leading to the development of non-hydrostatic pulmonary edema.
Since people with ARDS develop pneumonia, aspiration, sepsis, pancreatitis, and trauma, the treatment primarily focuses in addressing the co-morbidities and providing support. Mechanical ventilation (MV) is the foundation of ARDS management. The use of protective ventilation is a priority in this acute phase of lung inflammation. The evolution of systemic and pulmonary inflammation in the 1st week of mechanical ventilation determines the physiologic progression (resolving vs unresolving) and the outcome of the disease. To fight lung infection, which is pretty much commonly observed among ARDS patients, Antibiotics are given. Glucocorticoids as end-effectors of the hypothalamic-pituitary-adrenal axis are the most important physiologic inhibitors of inflammation, affecting hundreds of genes involved in stress-related homeostasis. Several experiments have observed that β2 agonists can help accelerate alveolar epithelial repair, injury to which is a considerable cause of ARDS. β2 agonists can increase sodium transport by activating β2 receptors on alveolar type I and type II cells, accelerating the resolution of pulmonary edema. Furthermore, experimental and human studies also vote in favor of Keratinocyte growth factor (KGF) considering it an important for alveolar epithelial repair. Statins—a class of drugs which is often prescribed by doctors to help decrease cholesterol levels in the blood— can be used to address inflammation, an additional pathological hallmark of ARDS. However, some studies have shown the results quite opposite, heralding them as non-beneficial neither in lowering the morbidity of ARDS in high-risk patients nor improving the clinical outcomes of ALI/ARDS patients.
According to various studies, neuromuscular blocking agents (NMBAs) induce reversible muscle paralysis, thus are important in the management of a large number of hospital patients. Pancuronium and Vecuronium are the most commonly used NMBAs for the management of ARDS. Although the use of NMBAs in ARDS treatment is not marginal, it remains highly debatable owing to inherent risks in patients in the ICU.
Other treatment options, which the patients with ARDS are generally prescribed include supplemental oxygen, prone positioning, use of paralytics, fluid management, and a technique called positive end-expiratory pressure (PEEP) to release excess fluid out of air sacs. These are given in combination with continuing treatment of the original illness or injury. Also, supportive treatment, such as intravenous fluid or food, may be needed.
However, the treatment is supportive in nature. Despite decades of research, treatment options for ARDS are restricted. Only a few pharmacological therapies have emerged for ARDS. Supportive care with mechanical ventilation remains the mainstay of management. In the off-label treatment options, STATIN therapy, NMBAs, and glucocorticosteroids are recommended because there is no approved therapy for this indication yet. There are relatively few treatments available for ARDS and mortality remains high at 35 to 45% in most studies due to organ failure, sepsis, age, and associated comorbid illness. Furthermore, unrecognized ventilator disconnections can quickly lead to hypoxemia and hypercarbia and cause cardiopulmonary collapse.Inadequate sedation and analgesia in a paralyzed patient can cause extreme psychologic distress. Besides confinements with treatments, ARDS diagnosis has always remained challenging owing to incomplete knowledge of the syndrome. Most ARDS cases are not diagnosed at any time during a patient’s stay in the intensive care unit (ICU) leading to a delayed diagnosis.
Thus, there is a need for potential therapeutic advancements in the Acute Respiratory Distress Syndrome Market to provide treatments that are curative in nature. Studies show that premium-price agents such as stem cell therapies and other pipeline candidates with a better clinical profile are soon to grace the ARDS market. Several pharmaceutical companies are investigating novel therapeutic agents strengthening the pipeline.
Key companies such as Faron Pharmaceuticals, BioMarck Pharmaceuticals, Athersys, Apeptico Forschung und Entwicklung GmbH, Alexion Pharmaceuticals, and PhaseBio Pharmaceuticals are proactively engaged in propelling Acute Respiratory Distress Syndrome Market Size creating a positive impact on the market. DelveInsight estimates that the Acute Respiratory Distress Syndrome market size is expected to grow at a CAGR of 9.55% for the study period 2017-30. The expected launch of emerging ARDS pipeline therapies, such as Traumakine (Faron Pharmaceuticals) BIO-11006 (BioMarck Pharmaceuticals), MultiStem (Athersys), Solnatide (Apeptico Forschung und Entwicklung GmbH), PB1046 (PhaseBio Pharmaceuticals), and others shall transform the ARDS market landscape. The market, which is dominated by supportive therapies soon will embrace innovative therapies that shall expedite the steady growth throughout the study period (2017–2030).
Overall, owing to the entry of upcoming ARDS pipeline therapies, increasing incidence of ARDS, and better awareness of the disease are expected to boost the growth of the market in the coming decade. An increase in the R&D in the field and a recent interest in the indication owing to the global coronavirus pandemic, a profound environment has been set up to accelerate the uptake of potential emerging therapies with better clinical profile. Thus, the market landscape offers immense opportunities to the pharmaceutical companies to explore and grab the share.