Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder, a common ailment that affects the colon. Some of the effects of IBS are gas, bloating, pain, constipation, and diarrhea. Long term management is required for IBS as it is a chronic condition. The symptoms of IBS can be controlled by bringing about changes in lifestyle and daily diet and by tackling stress if any. Severe signs and symptoms of IBS can be observed in very small groups of people who need treatment and counseling.
One among every five Americans have signs and symptoms of irritable bowel syndrome and very few seek medical assistance. Although classified as non-threatening, with an approximately 11% prevalence rate, irritable bowel syndrome is one of the most common GI disorders. IBS mostly occurs in people below the age of 45 and is twice more prevalent in women compared to men. Serious symptoms of IBS include rectal bleeding, weight loss, and severe abdominal pain in the night.
Based on the predominant symptoms, IBS can be classified into 3 types – IBS-D where diarrhea is the predominant symptom, IBD-C where constipation is the predominant symptom, and IBS-M with mixed symptoms. Common triggers for irritable bowel syndrome include food, hormones, stress, and other illness such as gastroenteritis and over growth of intestinal bacteria.
As the cause of irritable bowel syndrome is not clear, treatment is mainly focused on relieving the symptoms of IBS so that patients can live a normal life. Mild irritable bowel syndrome can be managed by changes in lifestyle and diet, whereas moderate to severe IBS requires medication. First line treatment for all types of IBS include dietary modification, exercise, counselling, and avoiding the triggers. If these treatment options do not help, anti-diarrheal drugs for IBS-D, and laxatives and fiber supplements for IBS-C are used. Antispasmodic are used to reduce the pain associated with IBS. However, overall relief provided by the mentioned treatments are not satisfactory and usually lead to adverse effects.
A number of new promising therapies that provide overall relief for IBS are being launched. Lotronex, a 5-HT3 antagonist launched in February 2000 by GlaxoSmithKline is effective in treating all the symptoms of IBS-D but was withdrawn from the market due to adverse reactions. It was subsequently reintroduced into the market in July 2002 to treat severe IBS only in women when all other therapies fail.
Some of the major drivers of the IBS drugs market are the rise in disease prevalence of IBS, increase in stress levels and lifestyle changes, favorable healthcare reimbursement policies, rise in healthcare investment, and rich late phase products pipeline. Restraints of the IBS drugs market include unsatisfactory effectiveness of the drugs, improper disease awareness, and low diagnosis of IBS.
On the basis of medication, the IBS drugs market is mainly divided into three types - drugs for the treatment of IBS-D such as Opioid µ-Receptor agonists, smooth-muscle relaxants, tricyclic antidepressants, and selective 5-HT3 receptor antagonists. Drugs for the treatment of IBS-C include bulking agents, osmotic laxatives, and drugs used to relieve pain such as smooth-muscle relaxants and tricyclic antidepressants. Currently, Lotronex and Amitiza are the only products available in the market approved by the U.S. FDA. With constant developments in understanding the pathophysiology of the disease, newer drugs with combined 5-HT3 antagonist and 5-HT4 agonist actions are under clinical advancement. Future therapies include Alizyme, Ramosetron, Dynogen etc. Better understanding of the pathophysiology of IBS has created opportunity for newer drugs in the market. Thus, it is more likely to foresee arrival of first class drug therapies in the near future, leading to fierce competition in the market.
On the basis of geography the IBS drugs market is divided into North America, Europe, Asia Pacific, Middle East and Africa, and Latin America. North America is the pre-dominant market for IBS drugs due to ample opportunities with favorable reimbursement policies. However, Asia Pacific is the fastest growing market for IBS drugs with Japan developing as the major market for IBD drugs, awaiting drug approvals. Linzess launched in 2013 is the only product available for IBD-C in Germany and the U.K. In Italy, anti-depressants and Xifaxan are used off-label in IBS patients for the management of the disease, indicating the need for first line therapies in the European market.
Some of the key players in the irritable bowel syndrome market are Allergan Plc., Sucampo Pharmaceuticals, Lexicon Pharmaceuticals, Inc., Pfizer Inc. Astellas Pharma Inc., Ironwood Pharmaceuticals, Inc., Novartis, Ono Pharmaceutical Co., Ltd., Synergy Pharmaceuticals, Takeda Pharmaceutical Company Ltd, and Abbot Laboratories.
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