Cardiotoxicity: Issues, Technologies, and Solutions for the Future

At least 50 companies have a claimed product or service relevant to cardiotoxicity screening, of which 29 have some clear focus on proarrhythmic cardiotoxicity or ion channel screening.

• 50 commercial entities that offer cardiotoxicity screening products/services
• The history and status quo of the current regulatory environment pertinent to drug-induced proarrhythmia
• Methods for assessing the potential for drug-induced cardiotoxicity, with a primary focus on proarrhythmia screening
• Drugs associated with cardiotoxicity, factors that may predispose to drug-induced cardiotoxicity, and current/proposed cardioprotective approaches
• A primer on cardiac anatomy/physiology, with particular consideration given to the various ion fluxes that contribute to the cardiac action potential
• Results of an Insight Pharma Reports cardiotoxicity survey undertaken for this report in December 2007

In addition, this report provides a subjective opinion on the future of cardiotoxicity screening, suggests how regulatory guidelines might change in the future, and outlines some commercial opportunities that might be associated with the current and future cardiotoxicity screening environment.

Ion currents across a cardiac myocyte cell membrane cause a sequence of voltage changes known as the action potential, which is the basis of the heartbeat. Drug-mediated interference with one or more of the ion channels that give rise to the action potential may cause potentially lethal arrhythmias. This could be brought about by direct binding of drug to ion channel proteins, or by indirect interference with ion channel function. The clinical outcome of drug-ion channel interactions could be potentiated by a variety of predisposing factors, such as concurrent disease, medication, genetic variations, age, and gender.

Additionally or alternatively, drugs may have more directly cytotoxic effects on cardiac cells, such as pro-apoptotic effects. In particular, the anthracyclines are commonly used in pediatric malignancies and breast cancer, and are associated with chronic cardiotoxicity. Hence, many cancer survivors have a higher risk of cardiovascular disease than of recurrent cancer.

Cardiotoxicity: Issues, Technologies, and Solutions for the Future provides a full discussion of both direct and proarrhythmic cardiotoxicity. This report identifies and discusses methods, products, and services that are designed to identify cardiotoxic compounds before they reach the market. It also outlines the main commercial competitors and suggests broad types of commercial opportunity and future merger and acquisition activity.