Ischemic stroke continues to be a graveyard for drug development, says Decision Resources, but market will grow to $450 million in 2018

Sales of agents to treat acute ischemic stroke will remain relatively flat over the next decade, increasing from $360 million in 2008 to $450 million in 2018 in the USA, France, Germany, Italy, Spain, the UK and Japan, says research and advisory firm Decision Resources.

The new Pharmacor report entitled Acute Ischemic Stroke finds that broadening the use of the recombinant tissue plasminogen activator (rt-PA; Genentech's Activase [alteplase, recombinant], other brands) and innovative therapies like stroke devices, such as Concentric Medical's Merci Retrieval System, will be important near-term advancements in the treatment of this indication. According to the report, drug-treatment rates for acute ischemic stroke will fluctuate modestly as the use of thrombolysis gradually increases, aided by continued improvements in stroke care throughout the major pharmaceutical markets.

Activase is now recommended for intravenous administration within 4.5 hours of stroke onset, as a result of recent positive clinical trial results from the third European Cooperative Acute Stroke Study (ECASS III). The report finds that the slowly expanding use of Activase will contribute to a modestly growing market through 2018, but a variety of limiting factors will continue to constrain the adoption of this and other time-sensitive treatments, and the promise of emerging therapies for acute ischemic stroke remains highly uncertain.

"In light of the recent discontinuations of several clinical-stage products, the stroke market continues to be a graveyard for drug development," said Decision Resources analyst Jonathan Searles. "While drug developers continue to investigate novel therapies to expand the stroke armamentarium, interviewed experts express their lingering doubts about the clinical potential of late-stage compounds such as Paion AG/Lundbeck's thrombolytic desmoteplase and D-Pharm's DP-b99, and they lament the historically high rate of attrition among stroke therapeutics,' he noted.