Dilated cardiomyopathy (DCM) is a significant cause of heart failure and a leading indication for heart transplant among children and adults across the globe. This condition is characterized by enlargement of ventricular chamber, thinning of heart walls and inability to sufficiently pump blood throughout the body.
Dilated cardiomyopathy can develop at any age but is more common among people aged between 20 years to 60 years. Genetic inheritance is found to affect about 30% to 40% of the total DCM patients. Single gene mutations in either the structural proteins of the myocyte, such as dystrophin, metavinculin, and lamin, or of mitochondrial DNA are also a prominent cause of DCM. Other factors such as diabetes, thyroid disorder, alcoholism, viral infections of the heart and heart valve abnormalities can also lead to dilated cardiomyopathy. Moreover, according to the Pediatric Cardiomyopathy Registry, DCM occurs at a rate of 6 per million children. It is commonly diagnosed in younger children with an average age of diagnosis at 2 years.
The global dilated cardiomyopathy therapeutics market is studied from two perspectives i.e. by drug class and by geography. Till date, there is no FDA approved drug specifically for dilated cardiomyopathy treatment. Owing to the aforementioned fact, the drug classes used in treatment of dilated cardiomyopathy are essentially the same as that for treatment of congestive heart failure.
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Some of the widely prescribed drug classes in dilated cardiomyopathy treatment encompass aldosterone antagonists, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs) and beta blockers. Angiotensin II receptor blockers acquired the largest market share by revenue in 2013, followed by beta blockers.
This is attributed to high demand for block buster drugs in dilated cardiomyopathy treatment especially in the developed regions such as North America and Europe. Aldosterone antagonists recorded high growth rate due to the identified positive impact of aldosterone antagonists when used in combination with either ARBs or ACE inhibitors in reducing the progression of Duchenne muscular dystrophy (DMD). Approval for this indication would further accelerate the overall sales of aldosterone antagonists, which in turn would positively impact market growth.
Rising incidences of congestive heart failure across the globe is a prominent growth driver for dilated cardiomyopathy therapeutics market as DCM is one of the leading causes of heart failure. Globally, dilated cardiomyopathy accounts for approximately 30% to 40% of the total congestive heart failure cases each year.
Owing to the alarming rise in incidences of congestive heart failure, several companies have initiated clinical trial studies to develop therapeutics specifically for dilated cardiomyopathy. For instance, Array BioPharma in 2015 is conducting a phase II study for its drug candidate ARRY-371797 for DCM treatment. Additionally, Celladon Corporation in 2014 completed its phase II study of MYDICAR for dilated cardiomyopathy treatment. Success of these clinical studies will boost the growth and demand for dilated cardiomyopathy therapeutics market in forthcoming years. However, promising gene therapy and availability of implantable devices (implantable cardioverter defibrillators (ICDs), heart pumps and pacemakers) are major restraints to the DCM therapeutics market.
Geographically, dilated cardiomyopathy therapeutics market is studied for four regions: North America, Europe, Asia Pacific and the Rest of the World. In terms of revenue, North America accounted for the largest market share in 2013 owing to rising incidences of congestive heart failure and high acceptance of branded drugs. In the U.S., DCM is prevalent in approximately five to eight people out of every 100,000 people.