Refractory Angina Market

• Factors driving the epidemiological growth of Refractory Angina comprises ageing population, prevalence of cardiovascular risk factors, increased awareness and diagnoses, and lifestyle changes. Recognizing these elements is crucial to develop strategies for prevention, early detection, and effective management of refractory angina.
• Refractory angina, despite optimal medical, percutaneous, and surgical treatments, remains a debilitating condition often labeled as "no option," posing a significant unmet clinical need. Widespread clinical acceptance and large randomized trials are essential to address crucial issues like mechanism of action, efficacy, logistics, and cost-effectiveness in developing novel treatments for these patients.
• Market growth drivers for the Refractory Angina market includes innovation in medical devices, increase in prevalent cases of Coronary artery disease (CAD), and the growing demand for improved quality of life.
• The refractory angina market dynamics are expected to change owing to a significant pipeline. Some of the key players involved in the development of novel therapies are Gene Biotherapeutics (Generx), XyloCor Therapeutics (XC001), and others.

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DelveInsight’s comprehensive report titled “Refractory Angina Market Insights, Epidemiology, and Market Forecast – 2034” offers a detailed analysis of Refractory Angina Treatment Market. The report presents historical and projected epidemiological data covering Total Prevalent Cases of Refractory Angina, Gender-specific Prevalent Cases of Refractory Angina, Age-specific Prevalent Cases of Refractory Angina, and Diagnosed and Treatable Cases of Refractory Angina. In addition to epidemiology, the market report encompasses various aspects related to the patient population. These aspects include the diagnosis process, prescription patterns, physician perspectives, market accessibility, treatment options, and prospective developments in the market across seven major markets: the United States, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan, spanning from 2020-2034.

The report assesses current treatment methods and identifies areas of unmet medical needs in Refractory Angina. It examines market opportunities and highlights potential avenues for improving therapies or interventions. This insightful analysis empowers stakeholders to make informed decisions regarding product development and strategic market planning.

Refractory Angina Treatment Market

Refractory Angina overview

Refractory angina is a chronic condition that causes angina due to insufficient blood flow to the heart muscle in cases of coronary artery disease (CAD). Patients with refractory angina have reproducible lifestyle-limiting symptoms of chest pain, shortness of breath, and easy fatigability. These symptoms are often due to totally occluded coronary arteries or diffuse coronary atherosclerosis that makes revascularization problematic.

Refractory angina is considered as a debilitating disease marked by angina-type pain and persistent cardiac discomfort. This sensation of pressure or pain in the chest is a result of insufficient blood flow to the heart muscle. This type of angina cannot be managed through a combination of optimal medical therapy, angioplasty, or bypass surgery. It is believed to be caused by reversible myocardial ischemia, which occurs when the heart does not receive enough blood in the presence of CAD.

Refractory Angina Treatment Market 

It is important to recognize that patients diagnosed with refractory angina are a diverse group, and in many cases, functional imaging may not reveal any signs of myocardial ischemia. However, regardless of the underlying cause, patients with persistent chest discomfort often attribute their symptoms to be cardiac in nature and may worry that they could be experiencing a life-threatening cardiac event. Therefore, a clinical suspicion should be based on a convincing clinical history of angina and circumstantial evidence that supports the diagnosis.

The management and treatment of refractory angina are segmented into three categories: pharmacological therapies, non-invasive, and invasive treatment. The core pharmacological-based treatment involves β-blockers, long-acting nitrates, and calcium-channel blockers. These traditional anti-angina agents exert their effect by reducing heart rate, myocardial contractility, and blood pressure which are important for patients with refractory angina. The noninvasive non-pharmacological treatment includes therapies such as enhanced external counterpulsation (EECP) and Transcutaneous Electrical Nerve Stimulation (TENS).

Refractory Angina Epidemiology

The epidemiology section of the Refractory Angina market report offers information on the patient populations, including historical and projected trends for each of the seven major markets. Examining key opinion leader views from physicians or clinical experts can assist in identifying the reasons behind historical and projected trends. The diagnosed patient pool, their trends, and the underlying assumptions are all included in this section of the report.

This section also presents the data with relevant tables and graphs, offering a clear and concise view of the prevalence of Refractory Angina. Additionally, the report discloses the assumptions made during the analysis, ensuring data interpretation and presentation transparency. This epidemiological data is valuable for understanding the disease burden and its impact on the patient population across various regions.

Key Findings

• As indicated by the analysis, the overall prevalence of angina is 4% in adult’s ≥20 years of age, which is approximately 8 million people in the United States.
• According to the analysis, the prevalence of angina varied widely across populations, from 0.73% to 14.4% (population-weighted mean 6.7%) in women and from 0.76% to 15.1% (population-weighted mean 5.7%) in men. Prevalence is observed to be strongly correlated within populations between the sexes.
• One of the analysis indicated that patients with chronic refractory angina differ from ordinary angina patients in three ways: first, patients with chronic refractory angina pectoris maintain their left ventricular function despite severe three-vessel disease; second, they do not experience severe arrhythmias and therefore their mortality is only about 5%; and third, their angina is debilitating.
• The prevalence of no-option disabling refractory angina is much smaller and was estimated to be 35,000 to 50,000 patients.
• As per our analysis, it was estimated that around 300,000 to 900,000 patients in the United States have refractory angina, with between 25,000 and 75,000 new cases diagnosed each year.
• Based upon the analysis, almost 2.3 million people in the UK are living with some form of coronary artery disease.
• As per the analysis, the prevalence of refractory angina pectoris was estimated to be 5% to 10% in stable CAD patients, possibly accounting for 50,000 to 100,000 new cases/year in the United States and 30,000 to 50,000 new cases/year in Europe.

Refractory Angina Market Outlook

The current scenario in the Refractory Angina Treatment Market Outlook predominantly relies on off-label pharmacological treatments, encompassing a range of medications such as beta-blockers (like Atenolol & Metoprolol), calcium channel blockers (such as Nifedipine), and both long and short-acting nitrates (including Isosorbide Mononitrate & Nitroglycerine). These medications are employed to mitigate symptoms and decrease myocardial oxygen demand through mechanisms like vasodilation and heart rate regulation.

Further exploration reveals therapeutic options like nicorandil and ivabradine, which offer alternative strategies for managing stable angina. Nicorandil operates similarly to nitrates by activating potassium channels, while ivabradine provides a distinct approach particularly suited for patients unable to tolerate traditional heart-rate-lowering agents.

Innovative pharmaceuticals like ranolazine introduce a novel mechanism of action. Ranolazine, a piperazine derivative, is believed to exert its anti-anginal effects by inhibiting ischemic-induced late inward Na+ currents, thereby preventing Ca2+ overload and reducing diastolic wall tension and extrinsic coronary artery compression. Additionally, it may enhance endothelial-mediated coronary vasodilatation.

While originally considered primarily as an anti-metabolic drug, ranolazine's therapeutic effects are observed at significantly lower concentrations than those required to inhibit myocardial fatty acid oxidation, demonstrating its potential as a promising avenue in refractory angina management.

With ongoing research and continued dedication, the future holds hope for even more effective treatments and, ultimately, a cure for this challenging condition. According to DelveInsight, the Refractory Angina market in the 7MM is expected to rise significantly during the study period 2020–2034.

Refractory Angina Drug Chapters

Refractory Angina Emerging Drugs

The refractory angina market size is expected to change owing to a significant pipeline. Some of the key players involved in the development of novel therapies are Generx by Gene Biotherapeutics XC001 by XyloCor Therapeutics, and others.

Generx (Ad5FGF-4): Gene Biotherapeutics

It is a first-in-class, disease-modifying, single-dose angiogenic gene therapy product candidate designed to improve cardiac perfusion and to increase the supply of oxygenated blood in patients with refractory angina and myocardial ischemia due to advanced coronary artery disease. The FDA has granted fast-track designation for the Phase III clinical investigation of Generx, recognizing that refractory angina is a significant unmet medical need. Currently, Generx is in Phase III clinical development to evaluate the safety and efficacy of the therapy (Ad5FGF-4) in patients with refractory angina due to myocardial ischemia.

XC001: XyloCor Therapeutics

XC001, an investigational gene therapy designed for refractory angina patients with limited treatment options, works by stimulating the development of new coronary blood vessels in regions of the heart experiencing inadequate blood supply. This approach, supported by both pre-clinical and clinical data, aims to alleviate debilitating chest pain and enhance patients' ability to engage in daily activities. Granted fast-track designation by the US FDA in May 2017, XC001 is currently undergoing Phase I/II clinical trials. The Investigational New Drug (IND) application for XC001 is active with the FDA, and enrollment in the refractory angina trial has been completed.

Note: Detailed emerging therapies assessment will be provided in the final report...

Refractory Angina Market Segmentation

DelveInsight’s ‘Refractory Angina Market Insights, Epidemiology, and Market Forecast – 2034’ report provides a detailed outlook of the current and future Refractory Angina market, segmented within countries and by therapies. Further, the market of each region is then segmented by each therapy to provide a detailed view of the current and future market share of all therapies.

Refractory Angina Market Size by Countries

The Refractory Angina market size is assessed separately for various countries, including the United States, EU4 (Germany, France, Italy, and Spain), the UK, and Japan. In 2023, the United States held a significant share of the overall 7MM (Seven Major Markets) Refractory Angina market, primarily attributed to the country's higher prevalence of the condition and the elevated cost of the available treatments. This dominance is projected to persist, especially with the potential early introduction of new products.

Refractory Angina Market Size Distribution

Refractory Angina Market Size by Therapies

Refractory Angina Market Size by Therapies is categorized into current and emerging markets for the study period 2020–2034. Despite the availability of targeted therapies, the accessibility and customization of off-label treatments like nitrates, beta-blockers, and calcium channel blockers remain prevalent in managing angina. This adaptability to individual patient needs contributes significantly to the revenue generated within the refractory angina domain by the off label drugs.

Refractory Angina Market Share Distribution for Therapies in 2034

Note: Detailed market segment assessment will be provided in the final report....

Refractory Angina Drugs Uptake

This section focuses on the sales uptake of potential Refractory Angina drugs that have recently been launched or are anticipated to be launched in the Refractory Angina market between 2020 and 2034. It estimates the market penetration of Refractory Angina drugs for a given country, examining their impact within and across classes and segments. It also touches upon the financial and regulatory decisions contributing to the probability of success (PoS) of the drugs in the Refractory Angina market.

Note: Detailed assessment of drug uptake and attribute analysis will be provided in the full report on Refractory Angina....

Refractory Angina Market Access and Reimbursement

DelveInsight’s ‘Refractory Angina – Market Insights, Epidemiology, and Market Forecast – 2034’ report provides a descriptive overview of the market access and reimbursement scenario of Refractory Angina.

This section includes a detailed analysis of the country-wise healthcare system for each therapy, enlightening the market access, reimbursement policies, and health technology assessments.

KOL Views

To keep up with current Refractory Angina market trends and fill gaps in secondary findings, we interview KOLs and SMEs working in the Refractory Angina domain. Their opinion helps understand and validate current and emerging therapies and treatment patterns or Refractory Angina market trends. This will support the clients in potential upcoming novel treatments by identifying the overall scenario of the market and the Refractory Angina unmet needs.

Refractory Anginam Market Insights

DelveInsight’s analysts connected with 50+ KOLs to gather insights; however, interviews were conducted with 15+ KOLs in the 7MM. These KOLs were from organizations, institutes, and hospitals, such as the Specialist Angina Service, Royal Brompton and Harefield NHS Foundation Trust, London, UK, Vascular Science Department, National Heart and Lung Institute, London, UK, Division of Cardiology, Department of Medical Sciences, Città della Scienza e della Salute Hospital, University of Turin, Turin, Italy, and others.

Note: Detailed assessment of KOL Views will be provided in the full report on Refractory Angina....

Refractory Angina Competitive Intelligence Analysis

We conduct a Competitive and Market Intelligence analysis of the Refractory Angina Market, utilizing various Competitive Intelligence tools such as SWOT analysis, Conjoint Analysis, and Market entry strategies. The inclusion of these analyses is contingent upon data availability, ensuring a comprehensive and well-informed assessment of the market landscape and competitive dynamics.

The emerging Refractory Angina therapies are analyzed based on various attributes such as safety and efficacy in randomized clinical trials, order of entry and other market dynamics, and the unmet need they fulfill in the Refractory Angina market.

Note: Detailed assessment of SWOT analysis and conjoint analysis will be provided in the full report on Refractory Angina...

Refractory Angina Pipeline Development Activities

The report offers an analysis of therapeutic candidates in Phase II and III stages and examines companies involved in developing targeted therapeutics for Refractory Angina. It provides valuable insights into the advancements and progress of potential treatments in clinical development for this condition.

Pipeline Development Activities

The report covers information on collaborations, acquisition and merger, licensing, patent details, and other information for emerging Refractory Angina therapies.

Refractory Angina Report Insights

• Refractory Angina Patient Population
• Refractory Angina Therapeutic Approaches
• Refractory Angina Pipeline Analysis
• Refractory Angina Market Size and Trends
• Refractory Angina Market Opportunities
• Impact of Upcoming Refractory Angina Therapies

Refractory Angina Report Key Strengths

• 11 Years Forecast
• The 7MM Coverage
• Refractory Angina Epidemiology Segmentation
• Key Cross Competition
• Highly Analyzed Refractory Angina Market
• Refractory Angina Drugs Uptake

Refractory Angina Report Assessment

• Refractory Angina Current Treatment Practices
• Refractory Angina Unmet Needs
• Refractory Angina Pipeline Product Profiles
• Refractory Angina Market Attractiveness
• Refractory Angina Market Drivers
• Refractory Angina Market Barriers

Key Questions Answered In The Refractory Angina Market Report

• How common is Refractory Angina?
• What are the key findings of Refractory Angina epidemiology across the 7MM, and which country will have the highest number of patients during the study period (2020–2034)?
• What are the currently available treatments for Refractory Angina?
• What is the disease risk, burden, and unmet needs of Refractory Angina?
• At what CAGR is the Refractory Angina market and its epidemiology expected to grow in the 7MM during the forecast period (2024–2034)?
• How would the unmet needs impact the Refractory Angina market dynamics and subsequently influence the analysis of the related trends?
• What would be the forecasted patient pool of Refractory Angina in the 7MM covering the United States, EU4 (Germany, France, Italy, and Spain), the UK, and Japan?
• Among EU4 and the UK, which country will have the highest number of patients during the forecast period (2024–2034)?
• How many companies are currently developing therapies for the treatment of Refractory Angina?

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