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Today, the increasing prevalence of Chronic Respiratory Diseases (CRDs) is one of the leading health challenges worldwide. CRDs affect hundreds of millions of people and cause huge mortality, morbidity, immense socio-economic burden, and disability-adjusted life years (DALYs).
Over the past few decades, significant research and development related to diagnosis, clinical research, and treatment of the CRDs have been achieved, however, the incidence of CRDs has also increased at a proportional rate. Environmental factors such as air pollution, tobacco consumption (smoking), occupational chemicals, poor diet and nutrition, exposure to dust, changing lifestyle, and lower respiratory infections during childhood have led to a dramatic increase in CRDs.
Chronic Respiratory Diseases (CRDs) are a range of diseases that affect the airways and other structures of the lung. It affects people from all age groups and results in reduced lung function with time. If not diagnosed and treated early it may affect the overall health and may also result in premature death. CRDs are not curable, however, treatment options are available that can help in managing and controlling the symptoms and improve the quality of life. Through this article, we present some of the most common Chronic Respiratory Diseases with a special focus on the treatment options and companies working in this particular CRD.
Chronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease (COPD) is a group of diseases that cause airflow blockage and breathing-related problems. Majorly low and middle-income countries are highly affected by COPD due to a lack of various preventative, diagnostic and therapeutic options.
As per the WHO, the global prevalence of COPD was 251 million in 2016 and an estimated 3.17 million deaths were caused by the disease in 2015 (that is, 5% of all deaths globally in that year). In the USA, nearly 16 million people are affected by COPD. Similarly, as per the British Lung Foundation, approximately one in five people in the UK develop asthma, COPD, or another long-term respiratory illness. COPD is the second most common lung disease in the UK after asthma in terms of diagnosed cases.
In recent years major advances in understanding pathophysiology and the natural history of the disease, clinical features, and treatment have been observed. Tobacco smoke (either active smoking or secondhand smoke) is one of the leading causes of Chronic Obstructive Pulmonary Disease. Similarly, air pollution and occupational dust and fumes also contribute significantly to the development of COPD. As per the epidemiological studies by Salvi et. al., n.d., between 20% and 40% of all COPD patients worldwide are nonsmokers, thus, although smoking is the main COPD risk factor, other conditions have to be considered as well.
During the early stages, the disease is largely asymptomatic, most of the cases are diagnosed at the moderate or severe/very severe stage, which is one of the most challenging issues with COPD. Despite being one of the leading causes of death, no new drug has been approved in the Chronic Obstructive Pulmonary Disease market in the last few years. Currently, the available therapies provide symptomatic relief, minimize the risk or severity of exacerbations, and reduce the risk of death. The available medications are yet to prevent the progression of lung destruction.
Major players such as Afimmune, Inmunotek S.L., Sanofi, Regeneron, Pulmotect, Pulmotect, Verona Pharma, and others are involved in developing therapies for Chronic Obstructive Pulmonary Disease. The expected launch of therapies is expected to change the treatment landscape of COPD in the upcoming years, but the prevalence is also expected to rise owing to the factors such as the increase in smoking and aging populations.
Obstructive Sleep Apnea Syndrome
Obstructive sleep apnea is a sleep disorder in which the person breathing stops repetitively while sleeping due to upper airway collapse. It is associated with oxygen desaturation and sleep fragmentation. OSA increases the risk of diseases such as hypertension, cardiovascular disease, stroke, daytime sleepiness, motor vehicle accidents, and also with the quality of life. According to DelveInsight’s estimate, diagnosed prevalent cases of obstructive sleep apnea in the 7MM were found to be 23,351,061 in 2017. Similarly, it is found to be more common in men than women.
The treatment options for the management of obstructive sleep apnea include continuous positive airway pressure (CPAP), oral appliance therapy, surgery, and lifestyle changes. CPAP is the best option for OSA and occupies the largest market share (devices). The lifestyle changes include weight loss or maintaining body positioning during sleep. At present, few companies in the sleep monitoring devices include Omran healthcare, ResMed, Nyxoah, Sana, and others. Sleep monitoring devices or CPAP help improve sleep and controlling symptoms. Similarly, companies strengthening the therapeutics pipeline for the treatment of obstructive sleep apnea (OSA) include Jazz Pharmaceuticals, RespireRx, Idorsia, Bayer, Apnimed, and others.
As per the WHO, 300 million people of all ages worldwide have asthma and around 250,000 people die of it every year. Lack of proper treatment is the most common reason for the high death rate due to asthma as the treatment is not available to the majority of the people affected by it. Underdiagnosed are other major challenges, particularly in low- and middle-income countries.
In asthma the air passages in the lungs become narrow due to inflammation and tightening of the muscles of the airways that make breathing difficult and result in coughing and wheezing. Various environmental, genetic, and lifestyle factors influence the occurrence of asthma. Asthma cannot be cured, however, with medication its symptoms can be controlled. Identifying and avoiding triggers is the best option against asthma, however, it is feasible every time. Quick-relief medicines and Long-term control medicines are available in the market to treat Asthma. Medications are either breathed directly into the lungs (inhaled), and in some cases are taken in the form of pills or liquids. Quick-relief medicines act swiftly and open up tight airways, while long-term control medicines are taken regularly to prevent symptoms. At the global level, some of the companies such as Amgen, AstraZeneca, GlaxoSmithKline, Regeneron Pharmaceuticals, and others are actively engaged in the development of new therapies for asthma. The launch of the therapies in the coming year is expected to improve the treatment scenario. To get a more detailed analysis on asthma, visit – Asthma: Rising Prevalence And The Key Challenges In The Management
As per the Cystic Fibrosis Foundation, “more than 30,000 people are living with cystic fibrosis in the United States, while around 1,000 new cases of CF are diagnosed each year. Similarly, more than 70,000 worldwide are living with CF”. Cystic fibrosis is a life-threatening genetic disorder that causes persistent lung infections and limits the ability to breathe over time. It can also affect the digestive system and other organs in the body.
Due to complex and multi-systemic involvement, cystic fibrosis (CF) requires special care and follow-up care. At present, there’s no cure for cystic fibrosis, however, therapies are available in the market that can reduce the symptoms and complications. Apart from the medication, the treatment pattern requires a normal diet with additional energy and unrestricted fat intake. Medications such as pancreatic enzyme supplements, multivitamins, mucolytics, antibiotics, bronchodilators, anti-inflammatory agents, and CFTR potentiators and correctors are recommended. Sometimes surgery or another type of medical procedure may be required. The cystic fibrosis therapeutics market has a promising outlook with many emerging therapies in the pipeline. Some of the major players in the global CF market such as Translate Bio, Proteostasis Therapeutics, Vertex Pharmaceuticals, Ionis Pharmaceuticals, and others have their candidate drug in the late phase of clinical development.
Allergic rhinitis also called hay fever, is an inflammation of the nasal membranes to some specific allergens such as pollen, dust, mould, or other elements in the air and result in sneezing, nasal congestion, runny nose, rhinorrhea, sinus pressure, or a combination of any of these. It occurs when the immune system sensitizes and overreacts to the allergen as if it were harmful.
As per the study by Cazzoletti et al., (2015), “rhinitis affects about 40 % of western populations and 25–50 % of patients with rhinitis are non-allergic. The prevalence of AR peaks around the age of 16–24 and decreases in the subsequent years up to the age of 65–70”. According to the study conducted by Agnihotri, N. T et al., (2019), nearly 60 million people in the United States are affected by allergic rhinitis, and around 80% of those diagnosed with it develop symptoms before age 20 years. Similarly, in the UK around 1 in every 5 people is affected with allergic rhinitis.
The treatment approaches for allergic rhinitis include medications, home remedies, and several alternative medicines. The person with allergic rhinitis tries to avoid or eliminate exposure to allergens in the first place. However, it is not always possible to avoid potential allergens. Currently, the AR therapeutics market majorly includes off-label therapies that help improve the signs and symptoms of the disease. Medications include the use of antihistamines, decongestants, eye drops, and nasal sprays, immunotherapy, and Sublingual immunotherapy (SLIT). Apart from the available therapies in the market, at present, the companies such as Inmunotek S.L., Regeneron Pharmaceuticals, and few others have their product in the pipeline. The launch of the therapies in the coming year is expected to significantly revolutionize allergic rhinitis market dynamics.
Apart from these, Pulmonary Hypertension, Chronic Bronchitis, Emphysema, Lung Cancer, Occupational Lung Diseases are some other CRDs that affect millions of people worldwide and result in very high mortality.
What lies ahead
The CRD today is a huge burden on the healthcare system and is increasing at an alarming rate. In order to globally reduce the burden of CRDs, the WHO has launched Global Alliance against CRDs (GARD) program, with a special focus on the low-income and middle-income countries. In these countries, CRDs often remain unrecognized and under-treated due to a lack of awareness and unavailability of treatment options. GARD aims to reduce the morbidity, disability, and premature mortality related to CRD. Similarly, the local governments at their level are also working on various initiatives and awareness programs to tackle the growing prevalence of these diseases.
To fulfil the enormous unmet medical needs, globally companies in the Chronic Respiratory Diseases (CRDs) therapeutics market are extensively working on the development of novel therapies against these diseases. Similarly, companies are also focusing on developing medical devices for the treatment of CRDs such as COPD, OSA, and asthma. In the coming years the improvement in the diagnosis methodologies, incremental health care spending across the world in the CRDs segment, and the launch of new and effective therapies will improve the dynamics of Chronic Respiratory Diseases and their burden.