The changing marketplace of antithrombotics: better than cheaper?
Next generation anticoagulant and antiplatelet agents have shown superiority over the current market leaders in clinical studies and are to challenge them before generics
La Merie S.L. reported in its most recent update of the Antithrombotics Competitor Pipeline that sales of the two leading antithrombotics enoxaparin and clopidogrel are rather being challenged by improved innovator drugs than by cheaper generics. The beefy market of major branded antithrombotics in 2007 was US$ 14.9 bln and attracts many companies to develop innovative successors. The leading anticoagulant enoxaparin is already being challenged by market launch of the first oral direct thrombin inhibitor from Boehringer Ingelheim. Oral direct Factor Xa inhibitors are the leading class of anticoagulants having shown superior effects over enoxaparin. Bayer's rivaroxaban is under regulatory review in the US and EU and leads the field with further 11 F. Xa inhibitors in clinical development. Oral antiplatelet agent clopidogrel from Sanofi-Aventis and Bristol-Myer Squibb posted 2007 sales of US$ 8.5 bln and faces competition from more than 14 clinical stage compounds directed at a variety of different targets. Prasugrel from Lilly and Daiichi Sankyo recently was shown to be superior over clopidogrel in reducing the risk of coronary in-stent thrombosis. These results and more were found in a search conducted by La Merie Business Intelligence.
The report provides information on competitor projects in development as novel anticoagulants and antiplatelet agents. Current major targets in anticoagulant R&D are improved drug delivery of low-molecular weigh heparins, improved antithrombin-III agonists, thrombin inhibitors and modulators, indirect and direct F. Xa inhibitors, dual thrombin and F. Xa inhibitors, other factors in the coagulation cascade (F. VIII, F. XI, IX, TF/VII). Antiplatelet R&D focuses on the platelet ADP and thrombin receptor, but new targets such as the von Willebrand Factor / glycoprotein Ib and VI are gaining weight among other new antiplatet approaches. Antithrombotic targets such as PAI-1 and TAFIa are still in the clinical exploratory phase.
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