Antianginal drugs are medications used to treat angina. This condition is the result of myocardial ischemia, which occurs due to an imbalance between myocardial blood supply and oxygen demand. Atherosclerosis is a symptom of coronary artery disease in which the arteries that carry blood to the heart are narrowed or blocked.
Several diagnostic tests are performed to determine the condition of angina, such as ECG, stress tests, echocardiography, nuclear stress tests, chest x-rays, blood tests, coronary angiography, CT scans, cardiac MRIs, and more. Antianginal treatment options include lifestyle changes, medications, angioplasty and stenting, or coronary artery bypass surgery.
The goal of drug therapy is to minimize symptoms and prevent the progression of coronary artery disease. Angina is further divided into stable, unstable and variant angina. Stable angina can be easily managed with medications and lifestyle changes, but unstable angina is more complex to treat and requires more attention.
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Nitrates are often used to treat angina. Angina causes the blood vessels to relax and dilate, allowing more blood to flow to the heart muscle. The US FDA recently approved “GoNitro”, a nitroglycerin sublingual powder from US-based Espero Pharmaceuticals, for acute relief of angina attacks in 2016.
Beta-blockers work to lower blood pressure by blocking the effects of the hormone epinephrine (adrenaline), making the heart beat more slowly and with less force. Combinations of nitrates and β-blockers are most commonly used to block tachycardia and produce a synergistic anti-ischemic effect. Additional and emerging antianginal drugs include nicorandil, ivabradine, ranolazine, and trimetazidine.
Oral dosage forms are most commonly used to manage angina. These include normal and extended release tablets and capsules, as well as sublingual dosage forms. These drug forms are available as unlabeled as well as labeled drugs.
According to the WHO, cardiovascular disease is the most common cause of death worldwide. About 17.7 million people died from heart disease in 2015, accounting for 31% of global deaths. The high prevalence of ischemic heart disease has become a medical and social problem, providing market opportunities for market players in all regions.
Trends in antianginal drug development include the use of synergistic combinations, ongoing clinical trials and other pharmacological developments, including new routes of administration, dosing regimens, etc. Clinical trials are also underway to find new compounds for treatment. Angina pectoris, which can improve a patient’s quality of life and minimize medical costs.
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The development of new drugs provides additional treatment options for the treatment of stable angina. Increased competition for generic versions of pharmaceuticals poses a threat to market players.
The global market for antianginal drugs is driven by an increase in ischemic heart disease, a growing geriatric population, adoption of a rich and westernized diet and consequent increase in smoking, obesity and diabetes. Several new research drugs are being tested to treat chronic angina and reduce the side effects of currently marketed drugs.
There is very little research activity to treat angina. Not many approvals have been granted for new compounds in the last few years limiting market growth. On the demand side, many patients with chest pain remain undiagnosed as likely to suffer from angina. In addition, non-compliance with cardiovascular drugs has been observed among patients suffering from cardiovascular diseases.
North America is a mature market for antianginal drugs, but has the highest market share. It is estimated that approximately 9.8 million Americans experience angina each year, with 500,000 new cases of angina each year. It was followed by the Western European market. EU5 is leading the market share due to its advanced health care facilities and good repayment scenarios.
The Asia Pacific region represents a huge market opportunity for the anti-anginal drugs market owing to the increase in cardiovascular problems and the improvement of healthcare facilities. The Middle East and Africa, followed by Eastern Europe, have the lowest market share, but the growing burden of ischemic heart disease in the region presents tremendous market opportunities.
Additionally, in a statement from IHME Professor Greg Roth, co-author of the Global Burden of Disease Study, “Ischemic heart disease, the leading cause of death in the United States, explains the opportunities for these therapies in low- and middle-income countries. world, and most of it happens outside the high-income world.”
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Competitive Outlook
Some of the players identified in the global Antiangina Drugs market include Pfizer Inc., MEDA Manufacturing GmbH, Valeant Pharmaceuticals International, Inc. and Gilead Sciences. There are regional and international players in the anti-anginal drugs market.
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