Published Date : 2021-11-09
Published Date : 2021-11-09
Updated On : 2023-09-11
Pages : 151
Thelansis’s “Familial Amyloid Polyneuropathy (FAP) Market Outlook, Epidemiology, Competitive Landscape, and Market Forecast Report – 2021 To 2032" covers disease overview, epidemiology, drug utilization, prescription share analysis, competitive landscape, clinical practice, regulatory landscape, patient share, market uptake, market forecast, and key market insights under the potential Familial Amyloid Polyneuropathy treatment modalities options for eight major markets (USA, Germany, France, Italy, Spain, UK, Japan, and China).
Familial amyloid polyneuropathy (FAP) is a neurodegenerative condition characterized by the abnormal accumulation of mutant transthyretin (TTR) amyloid fibrils outside of cells, primarily in the peripheral nervous system. Mutations in the TTR gene lead to the destabilization of the TTR protein, causing it to change from its normal tetrameric form into a form that can form amyloid fibrils. In countries where FAP is prevalent, it typically manifests as small fiber neuropathy that varies in severity based on the length of the affected nerves. There are several distinct types of FAP, such as the Portuguese, Japanese, and Swedish variants. While they share similar clinical characteristics, they differ in the age at which symptoms typically appear. For instance, Portuguese FAP can begin in a person's third or fourth decade, Japanese FAP typically emerges between ages 25 and 35, and Swedish FAP tends to start after age 55. Despite these differences, all three types share the underlying biochemical problem of producing abnormal or mutant forms of transthyretin. Therefore, they are collectively referred to as ATTR (familial ATTR). Transthyretin, previously known as thyroxin-binding pre-albumin, is a protein composed of four identical subunits and is a carrier for thyroxin and retinol-binding protein. Multiple amino acid substitutions in transthyretin can lead to the development of FAP, but the most common substitution is replacing valine with methionine at position 30 (Met-Val 30). This mutation is associated with FAP type 1 or the Portuguese, Japanese, and Swedish. In addition to transthyretin mutations, FAP can also rarely result from mutations in other proteins, including apolipoprotein A-1 (a high-density lipoprotein), fibrinogen A γ, lysozyme, and gelsolin (a cytoplasmic protein involved in actin filament interactions). The clinical symptoms of FAP type 1 ATTR neuropathy closely resemble those of AL amyloid neuropathy, with common signs of sensorimotor and autonomic neuropathy. FAP type 2, the Indiana type, is typically associated with transthyretin mutations at Ser84 or His58. Patients with this type often present with carpal tunnel syndrome and vitreous opacities, and their sensorimotor and autonomic neuropathies tend to be relatively mild. FAP type 3, or the Iowa type, is linked to an abnormal apolipoprotein A-1 and shares many similarities with FAP type 1. However, carpal tunnel syndrome is less frequently observed, and autonomic neuropathy is less pronounced. FAP type 4, the Finnish type, results from an abnormal gelsolin protein and manifests as a unique clinical syndrome featuring progressive cranial neuropathies and a distinctive thickening of facial skin. Sensorimotor and autonomic neuropathies associated with this type are typically mild. Liver transplantation (LT) is no longer considered the primary treatment for FAP, as its main goal is to remove the significant source of amyloidogenic TTR. LT can effectively stop disease progression by eliminating 95% of circulating TTR.
North America- the United States and Canada
Europe- EU5 (Germany, France, Italy, Spain, and the United Kingdom)
Other countries- Japan & China
This section of the study covers country-specific current clinical practice, the standard of care, and significant limitations around addressing the unmet needs. Retrospective analysis and bench-marking of clinical study outcomes are presented in terms of Pre-treatment & post-treatment clinical and demographic patient characteristics. Essentially, this section will cover the evolution of the current competitive landscape and its impact on the future treatment paradigm.
KOLs across 8 MM markets from the center of Excellence/ Public/ Private hospitals participated in the study. Insights around current treatment landscape, epidemiology, clinical characteristics, future treatment paradigm, and Unmet needs
- Data Inputs with sourcing
- Market Event and Product Event
- Country-specific Forecast Model
- Market uptake and patient share uptake
- Attribute Analysis
- Analog Analysis
- Disease burden and pricing scenario
- Summary and Insights
Optimization of cash flow/ revenue flow concerning all fixed and variable investments throughout the product development process. The rate of return on an investment is a critical indicator to ensure the profitability and break-even of the project.
The competitive landscape includes country-specific approved as well as pipeline therapies. Any asset/product-specific designation or review such as Orphan drug designation, Fast track, Priority Review, Breakthrough Therapy Designation, Rare Pediatric Disease Designation, and Accelerated Approval are tracked and supplemented with analyst commentary.
Detailed clinical trial data analysis and critical product positioning include trial design, primary outcomes, secondary outcomes, dosing and schedules, inclusion and exclusion criteria, recruitment status and essentially covers the reported adverse events. Majorly the trial analysis helps determine the potential of the critical assets and their probable filing and launch date.
This report presents the most important clinical unmet needs in the treatment, according to Thelansis research and analysis. Other essential unmet needs identified through our study include decreased cost burden on patients, improved administration convenience, and improved patient compliance.
S. no | Asset | Company | Stage |
1 | Inotersen | Ionis Pharmaceuticals, Inc. | Phase 3 |
2 | Vutrisiran | Alnylam Pharmaceuticals | Phase 3 |
3 | NTLA-2001 | Intellia Therapeutics | Phase 1 |
4 | Evuzamitide | Attralus, Inc. | Phase 2 |
5 | Tafamidis | Pfizer | Phase 3 |
6 | Acoramidis | Eidos Therapeutics, a BridgeBio company | Phase 3 |
KOLs across 8 MM market from the center of Excellence/ Public/ Private hospitals participated in the study. Insights around current treatment landscape, epidemiology, clinical characteristics, future treatment paradigm, and Unmet needs.
COUNTRY | No. Of KOLs |
USA | 17 |
GERMANY | 4 |
UK | 4 |
SPAIN | 3 |
FRANCE | 2 |
ITALY | 3 |
JAPAN | 3 |
CHINA | 4 |
Data Inputs with sourcing, Market Event, Product Event, Country specific Forecast Model, Market uptake and patient share uptake, Attribute Analysis, Analog Analysis, Disease burden, and pricing scenario, Summary, and Insights.
1. Familial Amyloid Polyneuropathy (FAP) – Key Findings Summary |
1.1. Clinical findings |
1.1.1. Disease overview |
1.1.2. Therapeutic practices |
1.1.3. Future outlook |
1.2. Commercial findings |
1.2.1. Familial Amyloid Polyneuropathy (FAP) market scenario 2021 |
1.2.2. Familial Amyloid Polyneuropathy (FAP) market scenario 2025 |
1.2.3. Familial Amyloid Polyneuropathy (FAP) market scenario 2032 |
2. Familial Amyloid Polyneuropathy (FAP) Overview |
2.1. Disease Introduction |
2.2. Pathophysiology |
2.3. Signs and Symptoms |
2.4. Risk Factors |
2.5. Etiology |
2.6. Classification |
2.7. Pathogenesis |
2.8. Diagnosis |
2.9. Complications |
2.10. Treatment Algorithm |
2.10.1. Treatment in US (guidelines) |
2.10.2. Treatment in EU-5 (guidelines) |
2.10.3. Treatment in Japan (guidelines) |
2.10.4. Treatment in China (guidelines) |
2.11. Treatment Goals for Familial Amyloid Polyneuropathy (FAP) |
2.12. Referral Patterns |
2.12.1. Referral Scenario in US |
2.12.2. Referral Scenario in EU-5 |
2.12.3. Referral Scenario in Japan |
2.12.4. Referral Scenario in China |
2.13. Familial Amyloid Polyneuropathy (FAP) Prognosis |
2.14. Healthcare burden |
2.14.1. Healthcare burden in US |
2.14.2. Healthcare burden in EU-5 |
2.14.3. Healthcare burden in Japan |
2.14.4. Healthcare burden in China |
2.15. Unmet Needs in Familial Amyloid Polyneuropathy (FAP) management |
2.16. Market Opportunity for Familial Amyloid Polyneuropathy (FAP) |
2.17. KOL Comments on current and upcoming/expected treatment practices in Familial Amyloid Polyneuropathy (FAP) |
3. Epidemiology |
3.1. Epidemiology Overview |
3.2. Epidemiology by Geography |
3.2.1. Familial Amyloid Polyneuropathy (FAP) Epidemiology in US (2021-2032) |
3.2.1.1. Incidence of Familial Amyloid Polyneuropathy (FAP) |
3.2.1.2. Diagnosed cases |
3.2.1.3. Treatable Patient Pool |
3.2.1.4. Epidemiology Trends |
3.2.2. Familial Amyloid Polyneuropathy (FAP) Epidemiology in EU-5 (2021-2032) |
3.2.2.1. Incidence of Familial Amyloid Polyneuropathy (FAP) |
3.2.2.2. Diagnosed cases |
3.2.2.3. Treatable Patient Pool |
3.2.2.4. Epidemiology Trends |
3.2.3. Familial Amyloid Polyneuropathy (FAP) Epidemiology in Japan (2021-2032) |
3.2.3.1. Incidence of Familial Amyloid Polyneuropathy (FAP) |
3.2.3.2. Diagnosed cases |
3.2.3.3. Treatable Patient Pool |
3.2.3.4. Epidemiology Trends |
3.2.4. Familial Amyloid Polyneuropathy (FAP) Epidemiology in China (2021-2032) |
3.2.4.1. Incidence of Familial Amyloid Polyneuropathy (FAP) |
3.2.4.2. Diagnosed cases |
3.2.4.3. Treatable Patient Pool |
3.2.4.4. Epidemiology Trends |
3.3. Epidemiology Trends (World-wide) |
4. Market Outlook |
4.1. US Familial Amyloid Polyneuropathy (FAP) Market Forecast 2021-2032 |
4.1.1. Market Progression (Futuristic) |
4.1.2. Market Trends and Expectations |
4.1.2.1. Worst case scenario |
4.1.2.2. Base Case Scenario |
4.1.2.3. Best Case Scenario |
4.1.3. Drivers and Barriers |
4.2. UK Familial Amyloid Polyneuropathy (FAP) Market Forecast 2021-2032 |
4.2.1. Market Progression (Futuristic) |
4.2.2. Market Trends and Expectations |
4.2.2.1. Worst case scenario |
4.2.2.2. Base Case Scenario |
4.2.2.3. Best Case Scenario |
4.2.3. Drivers and Barriers |
4.3. France Familial Amyloid Polyneuropathy (FAP) Market Forecast 2021-2032 |
4.3.1. Market Progression (Futuristic) |
4.3.2. Market Trends and Expectations |
4.3.2.1. Worst case scenario |
4.3.2.2. Base Case Scenario |
4.3.2.3. Best Case Scenario |
4.3.3. Drivers and Barriers |
4.4. Germany Familial Amyloid Polyneuropathy (FAP) Market Forecast 2021-2032 |
4.4.1. Market Progression (Futuristic) |
4.4.2. Market Trends and Expectations |
4.4.2.1. Worst case scenario |
4.4.2.2. Base Case Scenario |
4.4.2.3. Best Case Scenario |
4.4.3. Drivers and Barriers |
4.5. Italy Familial Amyloid Polyneuropathy (FAP) Market Forecast 2021-2032 |
4.5.1. Market Progression (Futuristic) |
4.5.2. Market Trends and Expectations |
4.5.2.1. Worst case scenario |
4.5.2.2. Base Case Scenario |
4.5.2.3. Best Case Scenario |
4.5.3. Drivers and Barriers |
4.6. Spain Familial Amyloid Polyneuropathy (FAP) Market Forecast 2021-2032 |
4.6.1. Market Progression (Futuristic) |
4.6.2. Market Trends and Expectations |
4.6.2.1. Worst case scenario |
4.6.2.2. Base Case Scenario |
4.6.2.3. Best Case Scenario |
4.6.3. Drivers and Barriers |
4.7. Japan Familial Amyloid Polyneuropathy (FAP) Market Forecast 2021-2032 |
4.7.1. Market Progression (Futuristic) |
4.7.2. Market Trends and Expectations |
4.7.2.1. Worst case scenario |
4.7.2.2. Base Case Scenario |
4.7.2.3. Best Case Scenario |
4.7.3. Drivers and Barriers |
4.8. China Familial Amyloid Polyneuropathy (FAP) Market Forecast 2021-2032 |
4.8.1. Market Progression (Futuristic) |
4.8.2. Market Trends and Expectations |
4.8.2.1. Worst case scenario |
4.8.2.2. Base Case Scenario |
4.8.2.3. Best Case Scenario |
4.8.3. Drivers and Barriers |
4.9. Key Expected Milestones (world-wide) Impacting the Market |
5. Competitive Landscape |
5.1. Pipeline Therapies Overview |
5.1.1. Phase III Therapies |
5.1.1.1. Current Status |
5.1.1.2. Trial details, results |
5.1.1.3. Approval Timeline |
5.1.1.4. Likelihood of approval |
5.1.1.5. Expected Product Positioning |
5.1.1.2. All other Phase III Therapies ….. |
5.1.1.3. Attribute Analysis of Phase III molecules |
5.1.2. Phase II and Phase I/II Therapies |
5.1.2.1. Current Status |
5.1.2.2. Trial details, results |
5.1.2.3. Approval Timelines |
5.1.3. List of active Pre-clinical Therapies |
5.1.3.1. Status in Familial Amyloid Polyneuropathy (FAP) |
5.1.3.2. Company positioning |
5.1.3.2. All other pre-clinical therapies |
5.1.4. List of Inactive/discontinued assets |
5.1.4.1. Business impact of discontinuations on current pipeline |
5.1.5. Potential winners from Familial Amyloid Polyneuropathy (FAP) Pipeline |
5.1.5.1. Potential Blockbusters across the pipeline |
6. Regulatory/Approval Scenario |
6.1. Regulatory/Approval Framework in US |
6.1.1. Policy Framework |
6.1.2. Payer Expectations |
6.2. Regulatory/Approval Framework in UK |
6.2.1. Policy Framework |
6.2.2. Payer Expectations |
6.3. Regulatory/Approval Framework in France |
6.3.1. Policy Framework |
6.3.2. Payer Expectations |
6.4. Regulatory/Approval Framework in Germany |
6.4.1. Policy Framework |
6.4.2. Payer Expectations |
6.5. Regulatory/Approval Framework in Italy |
6.5.1. Policy Framework |
6.5.2. Payer Expectations |
6.6. Regulatory/Approval Framework in Spain |
6.6.1. Policy Framework |
6.6.2. Payer Expectations |
6.7. Regulatory/Approval Framework in Japan |
6.7.1. Policy Framework |
6.7.2. Payer Expectations |
6.8. Regulatory/Approval Framework in China |
6.8.1. Policy Framework |
6.8.2. Payer Expectations |
7. Clinical Trial Assessment – Current and Future Paradigm |
7.1. Distribution of Primary Endpoints across trials |
7.2. Distribution of Secondary Endpoints across trials |
7.3. Evolution and acceptance of surrogate endpoints |
7.4. Key Investigator initiated trials |
7.5. Attrition analysis |
7.5.1. Suspended/Discontinued Assets |
7.5.2. Failed Trials, Reasons and Business Impact |
7.5.3. Terminated Trials, Reasons and Business Impact |
7.5.4. Withdrawn Trials, Reasons and Business Impact |
7.6. Trial enrollment scenario and challenges |
7.7. Clinical Trial Guidance (across geographies) |
8. Thelansis Commentary |
8.1. Key Unmet needs in Familial Amyloid Polyneuropathy (FAP) |
8.2. Possible Best-case Clinical Trial Strategies |
8.3. Possible Best Case Targeted Product Profile (TPP) |
8.4. Possible Best-case Market positioning strategies |
8.5. Possible Best-case Market Access Strategies |
8.6. Possible Best-case LCM Strategies |
8.7. Overall View on Familial Amyloid Polyneuropathy (FAP) Market in Dollar Value |
9. Report Methodology |
9.1. Secondary research |
9.2. Primary research |
9.3. Data collation |
9.4. Insight Generation |
10. About Thelansis |
10.1. Our Capabilities |
10.2. Our Services |
10.3. Our Contacts |
10.4. Disclaimer |