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市場調査レポート
商品コード
1286682
特発性膜性腎症(IMN)市場 - 市場の洞察、疫学、市場予測:2032年Idiopathic Membranous Nephropathy (IMN) - Market Insights, Epidemiology and Market Forecast - 2032 |
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特発性膜性腎症(IMN)市場 - 市場の洞察、疫学、市場予測:2032年 |
出版日: 2023年06月01日
発行: DelveInsight
ページ情報: 英文 138 Pages
納期: 2~10営業日
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2022年、特発性膜性腎症(IMN)の市場規模は米国が最も大きく、約1億米ドルを占めており、2032年にはさらに増加すると予測されています。
当レポートでは、主要7ヶ国における特発性膜性腎症(IMN)市場について調査し、市場の概要とともに、疫学、患者動向、新たな治療法、2032年までの市場規模予測、および医療のアンメットニーズなどを提供しています。
'DelveInsight's "Idiopathic Membranous Nephropathy (IMN) - Market Insights, Epidemiology and Market Forecast - 2032" report delivers an in-depth understanding of historical and forecasted epidemiology as well as market trends of IMN in the United States, EU4 (Germany, France, Italy, Spain) and the United Kingdom, Japan, and China.
IMN market report provides current treatment practices, emerging drugs, market share of individual therapies, and current and forecasted 7MM + China IMN market size from 2019 to 2032. The report also covers current IMN treatment practices/algorithms and unmet medical needs to curate the best opportunities and assess the market's potential.
Study Period: 2019-2032
IMN Disease Understanding and Treatment
IMN Overview
Membranous Nephropathy (MN), also known as membranous glomerulonephritis (MGN), is a rare autoimmune disorder characterized by a pathological change in the glomerular basement membrane (GBM) due to the deposition of subepithelial immune complexes. MN causes protein increase in urine, abnormal kidney function, and swelling. It is also called membranous glomerulopathy. MN is a rare disease affecting the kidney glomerulus, specifically the podocytes, which control the kidney's permeability to proteins. Albumin and higher molecular weight proteins are minimally filtered in a healthy individual. In contrast, in nephrotic syndrome, large amounts of proteins escape into the urine, decreasing serum albumin and developing generalized edema.
The most common symptom of MN is swelling, referred to as edema. This can range from mild to severe. Most people have some swelling, often the first symptom. In MN (as opposed to other diseases that cause protein in the urine and nephrotic syndrome), swelling is usually slow (over weeks to months), but it can sometimes come quickly. It typically starts in the feet, ankles, or legs but can occur anywhere in the body, including the abdomen, hands, arms, and face. It occurs due to fluid build-up in the body, specifically in different tissues.
Histologically, MN has been classified into primary and secondary types. Idiopathic or Primary MN is considered to be an antibody-mediated autoimmune disease, whereas secondary MN occurs in association with other diseases such as systemic lupus erythematosus (SLE), infections and malignancies, or exposure to toxins as well as certain medications such as non-steroidal anti-inflammatory drugs, TNF alpha-blockers, and other therapies.
IMN Diagnosis
The diagnosis of IMN is often diagnosed by evaluating protein in the urine (normally, there should not be protein in the urine). Others go to the doctor because of symptoms such as swelling, and blood and urine examinations reveal protein in the urine. The doctor may suggest examinations like urine tests, blood tests, etc. A blood test will help find protein, cholesterol, and waste levels in the blood. A kidney biopsy is a gold standard in confirming the diagnosis. In this test, a tiny kidney is removed with a special needle and looked at under a microscope. The kidney biopsy may show if you have a certain type of protein that helps the body fight infection, called an antibody. The body usually makes this antibody when you have MN. It is used either exclusively or in combination with antibody assay.
While the diagnosis of primary MN requires a kidney biopsy, recently, the availability of assays for PLA2R antibodies has dramatically changed the diagnostic strategy, owing to the very high specificity (99%) of anti-PLA2R antibodies for the diagnosis of MN.
Further details related to country-based variations are provided in the report…
IMN Treatment
The most severe cases of PMN are treated with immunosuppression. There is no cure for primary or secondary membranous nephropathy. With the patients having the condition, doctors focusing on the treatment generally adopt a symptomatic approach and try strengthening the patient's immune system.
Patients are started with supportive therapy regardless of underlying etiology as soon as the diagnosis is confirmed and continued for the course of the disease. It includes careful BP control, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker therapy to minimize proteinuria and enhance chances of spontaneous remission, statins for hyperlipidemia, salt restriction, and diuretics to control edema, and a low protein diet allowing for replacement of urinary protein losses. In recent studies, alkylating agents alternating with corticosteroids demonstrated favorable outcomes in patients with MN.
Some drugs/drug classes adopted to treat MN patients include immunosuppressive therapies (like steroids and alkylating agents, calcineurin inhibitors (CNIs), rituximab). The cornerstone of immunosuppression and immunosuppressive agents have been the alkylating agents plus steroids and calcineurin inhibitors (CNIs). Though they are partially successful in improving the reduction of proteinuria in MN patients, they have also been associated with higher relapse rates and major adverse reactions.
Some of the immunosuppressive therapies have received the most attention, and these include alkylating agents such as cyclophosphamide and chlorambucil, calcineurin inhibitors (CNIs) such as cyclosporine and tacrolimus, mycophenolate mofetil (MMF), rituximab, and adrenocorticotropic hormone (ACTH).
The treatment landscape of IMN is expected to change substantially and experience growth. The upcoming launch of innovative therapies such as SNP-ACTH (1-39) Gel, GAZYVA (obinutuzumab; RG7159), BRUKINSA (zanubrutinib), MOR202 (felzartamab), and others are expected to drive the market further.
As the market is derived using a patient-based model, the IMN epidemiology chapter in the report provides historical as well as forecasted epidemiology segmented by Prevalence of Idiopathic Membranous Nephropathy (including the addressable pool) and Prevalence of Idiopathic Membranous Nephropathy by Antigens, in the 7MM and China covering the United States, EU4 countries (Germany, France, Italy, Spain) and the United Kingdom, Japan, and China from 2019 to 2032. The total prevalent cases of Idiopathic Membranous Nephropathy in the 7MM and China comprised approximately 380,000 cases in 2022 and are projected to increase during the forecasted period
The drug chapter segment of the IMN report encloses a detailed analysis of IMN-marketed drugs and late-stage (Phase III and Phase II) pipeline drugs. It also helps understand the IMN clinical trial details, expressive pharmacological action, agreements and collaborations, approval and patent details, advantages and disadvantages of each included drug and the latest news and press releases.
Emerging Drugs
GAZYVA (Hoffmann-La Roche)
GAZYVA (obinutuzumab) is a humanized and glycoengineered type II anti-CD20 monoclonal antibody with superior in vitro B-cell cytotoxicity than rituximab. Obinutuzumab is directed at a different epitope on CD20 than that recognized by rituximab and can evoke a greater B-cell apoptotic response. Modifying the glycan tree structure at the Fc fragment of obinutuzumab leads to an increased affinity to FcgRIII, thereby potentiating antibody-dependent cellular cytotoxicity via natural killer cells' antibody-dependent cellular phagocytosis via macrophages.
MOR202 (MorphoSys)
MOR202/TJ202 (felzartamab) is a therapeutic human monoclonal antibody derived from MorphoSys' HuCAL antibody library and directed against CD38. In Membranous Nephropathy, long-lived plasma cells drive pathogenic antibody production, contributing to functional damage to the glomeruli in the kidney. By targeting CD38, Felzartamab has the potential to deplete the CD38-positive plasma cells, which may ultimately improve the patient's kidney functions.
Note: Detailed emerging therapies assessment will be provided in the final report.
Drug Class Insights
The current treatment of IMN consists of off-label therapies consisting of background therapies such as ACE inhibitors, ARB inhibitors, etc., and immunosuppressive therapies such as CNIs, rituximab, cyclophosphamide, etc.
Some of the immunosuppressive therapies have received the most attention, and these include alkylating agents such as cyclophosphamide and chlorambucil, calcineurin inhibitors (CNIs) such as cyclosporine and tacrolimus, mycophenolate mofetil (MMF), rituximab, and adrenocorticotropic hormone (ACTH). Among the calcineurin inhibitors (CNIs), cyclosporine is an established treatment option for iMN patients at moderate or high risk of disease progression. Another CNI that acts as an alternative treatment is tacrolimus.
There is no cure for membranous nephropathy. With the patients having the condition, doctor's focus on the treatment, generally, adopt a symptomatic approach, and try strengthening the patient's immune system. Patients are started with supportive therapy regardless of underlying etiology as soon as the diagnosis is confirmed and continued for the course of the disease.
Treatment includes careful BP control, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker therapy to minimize proteinuria and enhance chances of spontaneous remission, statins for hyperlipidemia, salt restriction, and diuretics to control edema, and a low protein diet allowing for replacement of urinary protein losses. In recent studies, alkylating agents alternating with corticosteroids demonstrated favorable outcomes in patients with MN. The 2012 Kidney Disease Improving Global Outcomes (KDIGO) guidelines rate this treatment regimen as the first line.
Because of the role of B cells in autoantibody production in membranous nephropathy combined with adverse effects of alkylating agents, corticosteroids, and calcineurin inhibitors, increasing amounts of observational data have emerged about the effectiveness of rituximab. However, a lack of randomized, controlled trials precluded consideration of rituximab as a first-line agent.
This has changed with the MENTOR study and will have implications for future guidelines and patient access to this drug. Some drugs/drug classes adopted to treat MN patients include immunosuppressive therapies (like steroids and alkylating agents, calcineurin inhibitors (CNIs), rituximab). The cornerstone of immunosuppression and immunosuppressive agents have been the alkylating agents plus steroids and calcineurin inhibitors (CNIs). Though they are partially successful in improving the reduction of proteinuria in MN patients, they have also been associated with higher relapse rates and major adverse reactions.
Key players such as Cerium Pharmaceuticals (SNP-ACTH [1-39] Gel), Hoffmann-La Roche (GAZYVA [obinutuzumab; RG7159]), BeiGene (BRUKINSA [zanubrutinib]), MorphoSys/ Human Immunology Biosciences (HI-Bio)/I-Mab Biopharma (MOR202 [felzartamab]), and others are evaluating their lead candidates in different stages of clinical development, respectively. They aim to investigate their products for the treatment of IMN.
This section focuses on the uptake rate of potential drugs expected to be launched in the market during 2019-2032. For example, for MOR202 (felzartamab), which is expected to be launched in the US in 2028, the drug uptake is expected to be medium, with a probability-adjusted peak patient share of ~20% in the US, expected to peak at 6 years from the year of launch.
Further detailed analysis of emerging therapies drug uptake in the report…
IMN Pipeline Development Activities
The report provides insights into different therapeutic candidates in Phase III, Phase II, and Phase I stage. It also analyzes key players involved in developing targeted therapeutics.
Pipeline Development Activities
The report covers information on collaborations, acquisitions and mergers, licensing, and patent details for IMN emerging therapies.
KOL Views
To keep up with current market trends, we take KOLs and SME's opinions working in the domain through primary research to fill the data gaps and validate our secondary research. Industry Experts contacted for insights on IMN evolving treatment landscape, patient reliance on conventional therapies, patient's therapy switching acceptability, and drug uptake, along with challenges related to accessibility, include Medical/scientific writers and Professors from renowned universities in the US, Europe, the UK, Japan, and China.
Delveinsight's analysts connected with 50+ KOLs to gather insights; however, interviews were conducted with 15+ KOLs in the 7MM and China. Centers like the Medicine Department of Ohio State University, the Department of Medicine, and Fred Hutchinson Cancer Research Center were contacted. Their opinion helped understand and validate current and emerging therapy treatment patterns of IMN market trends. This will support the clients in potential upcoming novel treatments by identifying the overall scenario of the market and the unmet needs.
Qualitative Analysis
We perform Qualitative and Market Intelligence analysis using various approaches, such as SWOT and Conjoint Analysis. In the SWOT analysis, strengths, weaknesses, opportunities, and threats in terms of disease diagnosis, patient awareness, patient burden, competitive landscape, cost-effectiveness, and geographical accessibility of therapies are provided. These pointers are based on the Analyst's discretion and assessment of the patient burden, cost analysis, and existing and evolving treatment landscape.
Conjoint Analysis analyzes multiple approved and emerging therapies based on relevant attributes such as safety, efficacy, frequency of administration, route of administration, and order of entry. Scoring is given based on these parameters to analyze the effectiveness of therapy.
In efficacy, the trial's primary and secondary outcome measures are evaluated; for instance, in trials for IMN, one of the most important primary endpoints is efficacy in reducing the intensity of IMN over time percentage of patients that respond to treatment. Based on these, the overall efficacy is evaluated.
Further, the therapies' safety is evaluated wherein the acceptability, tolerability, and adverse events are majorly observed. It sets a clear understanding of the side effects posed by the drug in the trials. In addition, the scoring is also based on the route of administration, order of entry and designation, probability of success, and the addressable patient pool for each therapy. According to these parameters, the final weightage score and the ranking of the emerging therapies are decided.
Market Access and Reimbursement
The cost of newly approved medications is usually high, and because of it, patients escape from proper treatment or opt for off-label and cheap medications. It affects market access to newly launched medications, and reimbursement is crucial. Often, the decision to reimburse comes down to the 'drug's price relative to the benefit it produces in treated patients. Market access and reimbursement options can differ depending on regulatory status, target population size, the setting of care, unmet needs, the magnitude of incremental benefit claims, and costs.
The report further provides detailed insights on the country-wise accessibility and reimbursement scenarios, cost-effectiveness scenario of approved therapies, programs making accessibility easier and out-of-pocket costs more affordable, insights on patients insured under federal or state government prescription drug programs, etc.
Key Questions
Market Insights
Epidemiology Insights
Current Treatment Scenario, Marketed Drugs, and Emerging Therapies