Ankylosing spondylitis is a systemic inflammatory disease that primarily affects the spine. In ankylosing spondylitis, the joints, ligaments, and spine become inflamed. The inflammation leads to pain and stiffness in the lower back of the body and progress into the upper spine, neck, and chest. The joints and bones (vertebrae) fuse together eventually, causing the spine to become rigid and inflexible. Fused spine is called as bamboo spine as it is identified on X-rays. Other joints such as the hips, ribs, and small joints of hands and feet are also affected.
Symptoms of the disease include pain and stiffness in joints, fever, fatigue, and loss of appetite. The global prevalence of ankylosing spondylitis is about 0.1% to 0.5%. This disease can occur at any age; however, it is common among the people from 19 to 40 years of age. It affects primarily men as compared to women. The prevalence ratio in male to female is 2.5:1. The precise cause of the disease is unknown, but it is believed to be hereditary, i.e., gene variation in HLA-B27. About 85% to 90% of people with the disease have HLA-B27 gene variation.
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The market is growing as no single therapy is approved. The available treatment is focused on reducing the discomfort caused due to ankylosing spondylitis. Current treatment options include nonsteroidal anti-inflammatory drugs (ibuprofen and naproxen); disease-modifying antirheumatic drugs (methotrexate); and biologics (secukinumab, certolizumab pegol, and infliximab). The market is expected to expand in the near future because of increase in research and development expenditure, rise in the number of treatment seeking population, and high unmet needs of current treatment in terms of appropriate drugs. However, loss of patent exclusivity of certain products such as etanercept and launch of biosimilars act as key restraints for the growth of the ankylosing spondylitis market.
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The global ankylosing spondylitis market can be segmented based on molecule type, route of administration, and geography. In terms of molecule type, the market can be segregated into small molecules, biologics, and biosimilars. The biologics segment is expected to grow as compared to the small molecules segment as the former segment has shown more promising results in clinical development. The biosimilars segment may change the landscape of the ankylosing spondylitis market as it is likely to impact on the cost of the treatment. Based on route of administration, the market can be divided into oral and parenteral. The parenteral segment is expected to grow as majority of molecules in the clinical development for ankylosing spondylitis are given via this route.
In terms of geography, the market can be classified into North America, Latin America, Europe, Asia Pacific, and Middle East & Africa. North America dominates the ankylosing spondylitis market, followed by Europe, due to higher incidence and prevalence rate, adoption of newer treatment options, and availability of improved diagnostic tools and health care infrastructure. Asia Pacific is an emerging market for ankylosing spondylitis due to the developing health care infrastructure, increasing patient pool, and rising government expenditure in the health care industry. However, affordability issues and lack of proper treatment are factors restraining the market growth in regions such as Middle East & Africa and Latin America.
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Major players operating in the global ankylosing spondylitis market include AbbVie Inc., Janssen Pharmaceuticals Inc., Pfizer Inc., Sandoz International GmbH, Amgen Inc., Protalix BioTherapeutics, Inc., Reliance Life Sciences Pvt. Ltd., Momenta Pharmaceuticals Inc., Celgene Corporation, Regeneron Pharmaceuticals, and Merck & Co. Inc.