Inflammatory Bowel Diseases: World Market Report 2009-2024

1 Executive Summary
1.1 Inflammatory Bowel Diseases (IBD) Market Trajectory
1.1.1 Visiongain’s Prediction for the IBD Market
1.1.2 Prevalence Rates Rising Worldwide
1.2 Aims, Scope and Format of the Report
1.2.1 Chapter Outline
1.3 Complexities of the IBD Market: Assessing Multiple Drug Categories
1.4 Research Methods

2 What Is Inflammatory Bowel Disease?
2.1 Definition and Diagnosis
2.2 Signs, Symptoms and Secondary Conditions
2.2.1 Bleeding Ulcers, Fistulae, Bowel Perforations, Toxic Megacolon
2.2.2 Pyoderma Gangrenosum
2.2.3 Primary Sclerosing Cholangitis
2.2.4 Malnutrition, Poor Nutrient Absorption and Stunting
2.3 Ulcerative Colitis
2.4 Crohn's Disease
2.5 Indeterminate Colitis: Distinguishing Crohn's Disease from Ulcerative Colitis
2.6 Causes / Aetiology of Inflammatory Bowel Disease
2.7 Prevalence
2.8 Socioeconomic Costs
2.8.1 The Individual Cost of IBD

3 Autoimmune Disorders
3.1 Brief Overview of the Immune System
3.2 What are Autoimmune Diseases / Disorders?
3.3 What Causes Autoimmune Disorders?
3.4 Why are Autoimmune Diseases Spreading in Developed Countries, but Not in Developing Countries?
3.4.1 The Hygiene Hypothesis
3.5 What Inflammation is and Why Inflammation is Dangerous
3.5.1 What is Inflamed in Inflammatory Bowel Disease?
3.5.2 The Costs and Consequences of Non-Treatment

4 Treatments for Inflammatory Bowel Diseases
4.1 The Goals of IBD Treatment
4.1.1 Producing Remission
4.1.2 Maintaining Remission
4.2 Drug Categories and their Mechanisms of Action
4.2.1 Aminosalicylates / 5-ASA / Mesalazine / Mesalamine
4.2.2 Corticosteroids
4.2.3 Immunomodulators
4.2.4 Antibiotics
4.2.5 Biologic Therapies / Monoclonal Antibodies
4.3 Surgical Treatments
4.3.1 Surgery for Ulcerative Colitis
4.3.2 Surgery for Crohn's Disease
4.4 The Leading Alternative Treatments: Hygiene Theory, Helminthic Therapy and Faecal Bacteriotherapy
4.4.1 Helminthic Therapy
4.4.2 Faecal / Fecal Bacteriotherapy / Human Probiotic Infusions (HPI)
4.4.3 Smoking

5 World IBD Market: Market Projection, Top Drug Projections
5.1 World Inflammatory Bowel Diseases Market, 2009-2024
5.1.1 The 5 Types of IBD Drugs
5.1.2 Other Drugs Cross-Indicated for IBD: Accounting for Monoclonal Antibodies
5.2 Lialda: Easier to Use, Growing in Significance
5.2.1 Unique Selling Point: Lialda is Lactose-Free
5.2.2 Lialda's Downside
5.3 Asacol
5.4 Entocort
5.4.1 Steroid Side Effects and Entocort EC
5.5 Pentasa
5.5.1 Excellent Safety Profile Assisting Pentasa's Sales
5.6 Salofalk
5.6.1 Salofalk Once-Daily
5.6.2 Salofalk and China Medical Sales Agreement
5.7 Budenofalk: 22% growth last year
5.7.1 Sales to be Boosted by New Sales Deal with Salix
5.8 Colazal: Losing Ground
5.9 Monoclonal Antibodies Forecasts
5.10 Remicade
5.10.1 Label Expansion Assisting Remicade's Sales
5.11 Humira
5.11.1 Label Expansion Behind Humira's Growth
5.11.2 Registered for Crohn's in US and EU; In Phase III for Crohn's in Japan
5.12 Cimzia
5.12.1 Challenged by the Committee for Medicinal Products for Human Use
5.13 Tysabri
5.13.1 Still Under Scrutiny for Liver Toxicity

6 Crucial Pipeline Developments: New Drug Targets, Innovative Delivery Technologies, and Cutting-Edge Treatments
6.1 Traficet-EN
6.2 Alicaforsen: Approved for Pouchitis, Cancelled for Crohn's, Under Assessment for UC
6.3 Rifaxamin
6.4 Myoconda: Is this the Cure for IBD?
6.5 Bupropion (Wellbutrin)
6.6 Abatacept (Orencia)
6.7 Polyketals: Technology to Deliver Drugs to Internal Inflammation
6.8 Extracorporeal Photopheresis (Light Therapy Outside of the Body): Uvadex (Methoxsalen)
6.9 A New Monoclonal Antibody Indicated for Crohn's Disease: Ustekinumab (Stelara)
6.10 Interleukins: Promising New Drug Targets (with a Table of Pipeline Interleukin Drugs)
6.11 Stem Cells: Prochymal by Osiris Therapeutics

7 Leading Companies
7.1 Procter & Gamble: 27% of the IBD Market
7.2 Ferring: Drug Originator and Innovator, but Limited Late-stage Pipeline
7.3 Shire
7.3.1 Lialda's Success and its Potential
7.3.2 Shire's Share of Pentasa
7.4 Dr. Falk
7.5 Prometheus Laboratories: Significance through IBD Drugs and Tests
7.5.1 Prometheus's Diagnostic and Genetic Analysis Tests: Frontiers of IBD Treatment
7.5.2 Serology Retrospective Results
7.5.3 Prometheus and Monoclonal Antibodies
7.6 Salix: Losing Colazal, Gaining US License to Budenofalk
7.7 Cosmo Pharmaceuticals / Cosmo Technologies: Watch this Company!
7.7.1 MMX Revenues

8 World Markets by Region
8.1 Changing Regional Market Share
8.2 North America: Slower Growth, Market Share in 2024 Compared with 2009
8.3 Europe: Retaining Market Share in the Long Term?
8.3.1 United Kingdom
8.3.2 Germany
8.3.3 Poland: Increasing in Market Relevance
8.4 Africa, Asia, Australasia: Growing Markets
8.4.1 The Incidence and Prevalence of IBD in Asia
8.4.2 Japan
8.4.3 Australia
8.4.4 China
8.4.5 India
8.5 Latin America

9 Strengths, Weaknesses, Opportunities and Threats of the IBD Market
9.1 Strengths
9.1.1 Monoclonal Antibodies: a Threat to Intestinal Anti-Inflammatories?
9.2 Weaknesses
9.2.1 Genotyping: A Dead End?
9.3 Opportunities
9.4 Threats
9.4.1 Cures and/or Vaccines?
9.4.2 Market Saturation
9.4.3 The World Economic Climate - Will this Limit Uptake of New IBD Drugs in a Nearly-Saturated Market?

10 Visiongain Interviews with Relevant Key Opinion Leaders
10.1 Interview with Marco Greco, Chairman of the European Federation of Crohn’s and Ulcerative Colitis Associations (EFCCA).
10.1.1 Public Awareness
10.1.2 Differences Between European Countries
10.1.3 Drug Companies’ Involvement in Awareness Campaigns
10.1.4 Unmet Medical Needs
10.2 Interview with Dr. Alan Fraser, Associate Professor of Medicine, University of Auckland, Director for Clinical Examinations at Auckland Hospital.
10.2.1 Autoimmunity vs. Infection Theories
10.2.2 Monoclonal Antibodies
10.2.3 Genotyping
10.2.4 Remaining Therapeutic Gaps
10.2.5 Future Treatments
10.3 Interview with Professor Thomas Borody, MD, PhD, Director of the Centre for Digestive Diseases (Sydney), and Executive Director and Chief Medical Officer of Giaconda Limited
10.3.1 Mycobacterium avium paratuberculosis (MAP) Infection and IBD Aetiology
10.3.2 IBD and HIV/AIDS
10.3.3 Monoclonal Antibodies and Immunosuppressant Treatments
10.3.4 Potential Cure(s)
10.3.5 Remicade and MAP
10.3.6 Genotyping
10.3.7 Crohn’s vs. Colitis
10.3.8 Future Therapies
10.3.9 Potential and Future of Myconda

11 Conclusions
11.1 IBD Market Sales Forcasts
11.2 The Market will be Stimulated by New Delivery Technologies and New Drug Targets
11.3 Many Drugs and Generics on the Market, but Poor Disease Management Means High Potential Drug Uptake
11.4 The IBD Market - Will Sales Growth Continue Steadily from 2009 to 2024?

List of Tables
Table 3.1 The Most Common Autoimmune Disorders, by Type
Table 4.1 IBD Drugs by Type, Chemical Name and Brand Name
Table 5.1 World Intestinal Anti-Inflammatories Sales Forecasts, 2009-2024
Table 5.2 Lialda Sales Forecast, 2009-2024
Table 5.3 Asacol Sales Forecast, 2009-2024
Table 5.4 Entocort Sales Forecast, 2009-2024
Table 5.5 Pentasa Sales Forecast, 2009-2024
Table 5.6 Salofalk Sales Forecast, 2009-2024
Table 5.7 Budenofalk Sales Forecast, 2009-2024
Table 5.8 Colazal Sales Forecast, 2009-2024
Table 5.9 Autoimmune-Indicated Monoclonal Antibodies Forecasts, 2009-2024
Table 5.10 Remicade Sales Forecast, 2009-2024
Table 5.11 Humira Sales Forecast, 2009-2024
Table 5.12 Cimzia Sales Forecast, 2009-2024
Table 5.13 Tysabri Sales Forecast, 2009-2024
Table 6.1 Interleukin-targeted Drugs Pipeline, by Phase and Company, 2008
Table 8.1 World Intestinal Anti-Inflammatories Sales Forecasts, 2009-2024
Table 8.2 World Market Sales Forecasts by Region, 2009-2024
Table 8.3 North America Sales Forecast, 2009-2024
Table 8.4 Europe Sales Forecast, 2009-2024
Table 8.5 Africa, Asia, Australasia Sales Forecast, 2009-2024
Table 8.6 Latin America Sales Forecast, 2009-2024
Table 9.1 Strengths and Weaknesses in the IBD Market
Table 9.2 Opportunities and Threats in the IBD Market

List of Figures
Figure 2.1 Direct and Indirect Medical Costs of IBD in 4 Countries
Figure 5.1 World Intestinal Anti-Inflammatories Market Projection, 2009-2024
Figure 5.2 IBD Market Breakdown by Drug Type, 2008
Figure 5.3 Top-Selling IBD Drugs, 2008
Figure 5.4 Sales Forecasts of Top-Selling IBD Drugs, 2009-2024
Figure 5.5 Lialda Sales Forecast, 2009-2024
Figure 5.6 Asacol Sales Forecast, 2009-2024
Figure 5.7 Entocort Sales Forecast, 2009-2024
Figure 5.8 Pentasa Sales Forecast, 2009-2024
Figure 5.9 Salofalk Sales Forecast, 2009-2023
Figure 5.10 Budenofalk Sales Forecast, 2009-2024
Figure 5.11 Colazal Sales Forecast, 2009-2024
Figure 5.12 Autoimmune-indicated Monoclonal Antibodies Forecast
Figure 5.13 Remicade Sales Forecast, 2009-2024
Figure 5.14 Humira Sales Forecast, 2009-2024
Figure 5.15 Cimzia Sales Forecast, 2009-2024
Figure 5.16 Tysabri Sales Forecast, 2009-2024
Figure 7.1 Top IBD Companies, 2008
Figure 8.1 World Intestinal Anti-Inflammatories Sales Forecast, 2009-2024
Figure 8.2 Regional Sales Forecasts, 2009-2024
Figure 8.3 Market Share by World Region, 2014 Projection
Figure 8.4 Market Share by World Region, 2024 Projection
Figure 8.5 North America Sales Forecast, 2009-2024
Figure 8.6 Europe Sales Forecast, 2009-2024
Figure 8.7 Africa, Asia, Australasia Sales Forecast, 2009-2024
Figure 8.8 Latin America Sales Forecast, 2009-2024