Open-angle glaucoma market

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Open-angle glaucoma is a chronic, progressive, and irreversible multifactorial optic neuropathy that is characterized by open-angle of the anterior iridocorneal chamber, typical optic nerve head changes, gradual loss of peripheral vision (characteristic visual field changes) followed by central visual field loss (blindness) for which intraocular pressure (IOP) is a significant risk factor.

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Open-angle glaucoma treatment market Open-angle glaucoma is a chronic progressive and irreversible multifactorial optic neuropathy that is characterized by open-angle of the anterior iridocorneal chamber typical optic nerve head changes gradual loss of peripheral vision characteristic visual field changes followed by central visual field loss blindness for which intraocular pressure IOP is a significant risk factor. Open-angle glaucoma is the commonest form of glaucoma and a significant cause of blindness. High intraocular pressure IOP is a considerable risk factor for the disease. Open-angle glaucoma treatment aims to lower the IOP and thus reduce the risk of progressive loss of vision. IOP can be reduced by medications eye drops laser therapy or surgery. Open-angle glaucoma treatment should be initiated if signs of damage as a result of open-angle glaucoma are evident such as disc haemorrhage nerve fibre layer defects asymmetric cupping vertical ovalization or notching of the cup or if symptoms of elevated IOP are present e.g. halos blurred vision pain IOP consistently above 28 mmHg to 30 mmHg due to the high risk of optic nerve damage. The targeted intraocular pressure should be achieved with the fewest medications and minimum adverse effects. Several different classes of pressure-lowering medicines are available and medication choice may be influenced by cost adverse effects and dosing schedules. In general prostaglandin analogues Latanoprost travoprost bimatoprost etc. are the first line of medical therapy. These are the active market holders in Glaucoma treatment market and major players for open-angle glaucoma. These drugs reduce intraocular pressure by reducing outflow resistance resulting in increased aqueous humour flow through the uveoscleral pathway. However they are associated with local adverse effects such as conjunctival hyperemia elongation and darkening of eyelashes prostaglandin-associated periorbitopathy and others. If there is an intolerance to the use of prostaglandin analogues the second-line agents such as β-Adrenergic blockers Timolol Betaxolol etc. α agonists Apraclonidine Brimonidine Carbonic anhydrase inhibitors Dorzolamide Brinzolamide cholinergic agonists Pilocarpine are used. Although drugs such as the β-adrenergic blockers and α-adrenergic agonists are active only during the day and not at night as well as some of these agents such as β-adrenergic blockers may also have significant systemic adverse effects. Moreover combinatorial therapy of these medications can be used. The FDA approval of new classes of nitric oxide-donating compounds Vyzulta developed by Bausch Lomb’s and Rho-kinase ROCK inhibitors Rhopressa developed by Aerie Pharma open up new possibilities in market and research. Rhopressa is the first entirely new class of glaucoma medication to be available since latanoprost was approved. It is FDA-approved treatment that lowers eye pressure in patients with open-angle glaucoma and ocular hypertension. Vyzulta is combinatorial therapy of Lomb/Nicox making this the first drug to reduce stress while simultaneously dilating blood vessels to enhance blood flow in open-angle glaucoma patients. Both medications occupied a decent share hold in the Glaucoma market. If the first- and second- line treatment does not achieve adequate intraocular pressure reduction with acceptable adverse

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effects laser or incisional surgeries are indicated. In poorly adherent patients or those with severe disease surgery may sometimes be offered as first-line therapy. Despite all these available treatments unfortunately no competent evidence exists that these agents can prevent disease progression in patients with open-angle glaucoma which is the major impediment in Open-angle glaucoma market growth. In part neuroprotection has not succeeded because of an incomplete understanding of the pathophysiological mechanisms associated with optic nerve damage. The detailed knowledge of pathophysiology may change and drive the Open- angle glaucoma treatment market in the future. The frequent research has been directed toward understanding the disease at the cellular hormonal and molecular levels in order to overcome the current unmet needs. The future holds the hope of developing drugs that target the autoregulatory function of the capillaries serving the optic nerve head with the expectation that better vascular perfusion will help retard the morbidity of the disease. Moreover acquisitions and collaborations between key players research and development along with the emerging pipeline drugs are expected to create a productive environment as well as the launches of upcoming therapies will also provide to the overall growth of Open-angle glaucoma market during the forecast period of 2019–2028.

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