Metabolic Syndrome: Pipeline Analysis and U.S. Market Forecast

Table of Contents

Chapter 1: Introduction

• 1.1. Metabolic Syndrome: A Multifaceted Syndrome by Many Names
• 1.2. Etiology of Primary Components: The Vicious Cycle of "Diabesity"
• 1.3. Further Sequels: Endothelial Dysfunction, Inflammation, and Psychiatric Implications
• 1.4. The National Institutes of Health ATP III Guidelines and Definition

Chapter 2: Epidemiological Aspects

• 2.1. Overweight/Obesity and Lack of Physical Activity
• 2.2. Insulin Resistance and Diabetes
• 2.3. Elevated Blood Pressure and Hypertension
• 2.4. Dyslipidemia
• 2.5. Estimates for Prevalence and Incidence of the Metabolic Syndrome

Chapter 3: Current Options for Pharmacological Intervention

• 3.1. Limited Potential for Lifestyle Modifications
• 3.2. Current Pharmacological Treatment of Component Entities
• Drugs for Insulin Resistance and Emerging Type 2 Diabetes
  • -Sulphonylureas--Stimulators of Basal Insulin Release
  • -Post-Prandial Insulin Secretion Stimulators--the "Meglitinides"
• Insulin Sensitizers
  • -Metformin (Bristol-Myers Squibbs glucophage/glucamet; generics)
  • -Glitazones--The Original PPAR Agonists
    • --Avandia (rosiglitazone maleate, GlaxoSmithKline)
    • --Actos (pioglitazone HCl, Eli Lilly and Takeda)
  • -Glitazone/Metformin Fixed Combination Products
  • -Alpha-Glucosidase Inhibitors: Intestinally Acting Glucose Retardants
• Drugs for Dyslipidemia: Fibrates, Statins, and Niacin
  • -Fibrates
    • --Lopid (Pfizers gemfibrozil and generics)
    • --TriCor/Lipanthyl/Lipidil (fenofibrate, Abbott Laboratories and Groupe Fournier; generics)
    • --Bezalip (Roches bezafibrate)
    • --Lipanor/Modalim (Sanofi-Aventis ciprofibrate)
  • -Statins
  • -Cholesterol Absorption Inhibitors
    • --Ezetimibe (Schering-Plough/Merck & Co.s Zetia)
  • -Niaspan and Advicor
• Hypertension: Drug Class Differences in the Metabolic Effects
• Weight Reduction Agents
  • -Xenical (orlistat, Roche)
  • -Meridia/Reductil (sibutramine, Abbott Laboratories)
  • -"Short-Term Slimmers": No Relevance to the Metabolic Syndrome

Chapter 4: Unmet Treatment Need in the Metabolic Syndrome

• 4.1. Unmet Need in Current Drugs and Treatment Schedules
  • Weight Reduction Drugs
  • Glucose-Lowering Drugs
  • Lipid-Lowering Drugs
  • Anti-Hypertensive Drugs
• 4.2. Genetic Predisposition and Tailored Therapies: A Great Task Ahead
• 4.3. Unconventional Approaches: A Role for Neurotrophic Factors?
• 4.4. Summary

Chapter 5: Improvements Ahead--Breakthroughs on the Horizon?

• 5.1. Pharmacological Strategies to Support Weight Loss: A Bumpy Road
  • Regenerons Axokine: A Nerve Growth Factor Agonist Completing Clinical Development
  • Acomplia (rimonabant) and Other CB1 Receptor Antagonists for Slimming
  • New Pancreatic Lipase Inhibitors in the Pipeline
  • Symlin (Pramlintide acetate, an Analog of Amylin)
  • An Appetite Suppressant from a South African Cactus
  • Targeting the Adrenergic System--Adjusting the Metabolic Rate
  • 5-HT2c Receptor Agonists
  • Neuropeptide Y Receptor Agonists
  • Melanocortin Receptor Agonists
• 5.2. Potential Treatments for Insulin Resistance and Diabetes
  • Dual PPAR Stimulators--A New Class of Drugs Tailored to Metabolic Syndrome Therapy
  • Dipeptidyl Peptidase Inhibitors--Blocking Degradation of Glucagon- Like Peptide 1
  • Glucagon-Like Peptide Analogs
  • Sodium-Dependent Glucose Co-Transporter (SGLT) Inhibitors
  • An Antisense PTP-1B Gene Silencer
• 5.3. New Developments in Lipid Disorders
  • Cholesteryl Ester Transfer Protein (CETP) Inhibitors
  • Ibrolipim: A Lipoprotein Lipase Activator
  • An Antibody Mix for Dyslipidemia
  • Inhibition of Acetyl-CoA Carboxylase
  • Antisense Drugs
  • Omacor, an FDA-Approved Nutritional Supplement
• 5.4. Targeting Hypertension in the Metabolic Syndrome
  • Renin Inhibitors
  • Selective Aldosterone Blockade
  • Endothelin A Receptor Antagonists
• 5.5. Potential Improvements in the Therapy of Gout

Chapter 6: U.S. Market Forecast for Metabolic Syndrome Component Disorders: 2003-2018

• 6.1 United States Market Forecast for Dyslipidemia
  • Market Overview
  • Patent Expirations
  • Drug Launches
  • Epidemiology
• 6.2. United States Market Forecast for Type 2 Diabetes
  • Market Overview
  • Patent Expirations
  • Drug Launches
  • Epidemiology
• 6.3. United States Market Forecast for Obesity
  • Market Overview
  • Patent Expirations
  • Drug Launches
  • Epidemiology
• 6.4. United States Market Forecast for Hypertension
  • Market Overview
  • Patent Expirations
  • Drug Launches
  • Epidemiology

Chapter 7: Pipeline and Research Program Profiles

• 7.1. Sanofi-Aventis
• 7.2. Eli Lilly
• 7.3. Novo Nordisk
• 7.4. Bristol-Myers Squibb
• 7.5. GlaxoSmithKline
• 7.6. Roche
• 7.7. Merck & Co./Banyu
• 7.8. DeveloGen
• 7.9. Wellstat
• 7.10. Amylin Pharmaceuticals
• 7.11. Ligand Pharmaceuticals
• 7.12. Regeneron Pharmaceuticals
• 7.13. Biovitrum