Dyslipidemia diagnostics: fueling market expansion
The diagnosis of existing dyslipidemia can only be made with the aid of in vitro diagnostics. Currently dyslipidemia is diagnosed by measuring plasma lipid and lipoprotein biomarkers such as total cholesterol, LDL-C, HDL-C, and triglycerides. A standard lipid panel can be used to assess cardiovascular risk, although it may not provide satisfactory diagnostic accuracy in assessing an individual's risk of cardiovascular events. The use of lipoprotein subfraction testing, in particular LDL subfraction testing, is slowly growing. This approach can potentially improve the characterisation of risk associations with cardiovascular disease. The apoB/apoAI ratio represents the balance of proatherogenic and antiatherogenic lipoproteins and has been found to be the best predictor of risk. Lp(a) determination is being recognized as a significant independent marker for assessment of the risk of coronary heart disease. Many additional biomarkers of risk are emerging. They include biomarkers of oxidative stress, inflammation, and plaque instability.Various approaches may enable pharmaceutical companies to safeguard their revenues, but they will all require more widespread application of both simple and customized diagnostic tools. Diagnostic companies are in a position to drive the expansion of the dyslipidemia therapies market, but to do so they will need an informed understanding of current and emerging trends.
Initially strategies to promote the use of statins, fibrates, niacin and other lipid-modulating treatments will focus on the obese and diabetic populations, but these are not the only currently undertreated populations. Women as a group represent another undertreated category, as do the elderly of both sexes. Other populations whose needs are currently incompletely met include hypertensives, rheumatoid arthritis patients, HIV patients, renal insufficiency patients and schizophrenia patients. The type and degree of dyslipidemia in these patients needs to be accurately determined before lipid-modifying treatment is instigated, and the response to treatment monitored.
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