Increasing Diabetes Prevalence and Number of Transplants Push Mucormycosis Market
Mucormycosis (erstwhile, zygomycosis), a rare fungal disease can turn fatal if left untreated. The fungal infection caused by a group of moulds known as mucormycetes, has an overall mortality rate of 54%. As per the United States Centers for Disease Control and Prevention (CDC) estimates, the disease has a yearly rate of 1.7 cases per 1 million population in the US. While the disease affects lungs, sinuses, and brain, and can be life-threatening in diabetic, cancer, and HIV patients, its progression to advanced stage can cause a mutilating damage to nose, face, or eyes with disfigurement and vision loss. There have also been some cases of invasive brain infection due to mucormycosis.
Mucormycosis is a causing disease and may lead to fatality in ICU transplants, and immunocompromised patients. In a surveillance study conducted by CDC during 2001-2006, mucormycosis was the third most common type of invasive fungal infection in stem cell transplant recipients (~8%), and 2% among solid organ transplant recipients. The growing diabetic population and an increasing number of transplant surgeries globally will boost the growth of mucormycosis diagnostics as well as treatment market.
Mucormycosis Maiming COVID-19 Survivors in India during Chaotic Second Wave
Although most cases of mucormycosis are sporadic, the recent upsurge in COVID-19 cases in India has increased the threat of mucormycosis in COVID-19 survivors. Mucormycosis is more likely affecting the recovered patients possibly due to extended administration of steroid and immunosuppressant medications. COVID-19 patients with pre-existing comorbidities, and diabetic people exposed to steroids and humidified oxygen for a long duration are those at maximum risk. Multiple cases of mucormycosis re-emergence have been reported among COVID-19 patients at hospitals in India. Sion Hospital in Mumbai (Corona hotspot city in India), has reported 24 cases of the fungal infection in the month of March and April, up from six cases a year otherwise. The magnitude and the frequency of mucormycosis prevalence amid the second wave of pandemic are creating a challenging situation for doctors and other healthcare providers as well.
Rhinocerebral Mucormycosis Most Commonly Seen
There are typically five types of mucormycosis - rhinocerebral (sinus and brain), pulmonary (lung), gastrointestinal, cutaneous (skin), and disseminated. Among these, rhinocerebral mucromycosis is seen more commonly, especially in patients with uncontrolled diabetes, or those who have undergone a kidney transplant. Whereas, in cancer patients, or organ or stem cell transplant recipients, pulmonary mucormycosis remains the most commonly affecting type of the disease. Rhizopus species, Mucor species, Rhizomucor species, Syncephalastrum species, Cunninghamella bertholletiae, Apophysomyces species, and Lichtheimia (formerly Absidia) species are among the most common fungus types causing mucormycosis.
Tissue Biopsy Remains the Mainstay of Diagnosis; Antifungal Agents Lead Treatment Regimen
Though mucor is difficult to routinely culture, biopsy is the main laboratory diagnostic test for mucormycosis. Other rapid tests include laboratory screening tests such as KOH mount (for potassium hydroxide) and Calcofluor White Stain. Tissue biopsy benefits offset its risks in cases of coagulopathy or location inaccessibility. Other imaging techniques such as magnetic resonance imaging (MRI) and computed tomography (CT) are also essential for mucormycosis testing. Mucormycosis at early stages is usually treated with amphotericin B, posaconazole, or isavuconazole, typically administrered intravenously (amphotericin B, posaconazole, isavuconazole), or orally (posaconazole, isavuconazole). Amphotericin B has been the standard first line of treatment for invasive mucormycosis, whereas surgical debridement is a pivotal mucormycosis management therapy. Adjuvant therapy with deferasirox, statins, caspofungin, aspirin, and hyperbaric oxygen needs to be considered on the sidelines.
Europe Key Contributor; Asia Pacific Witnessing Rapidly Expanding Patient Population amid Pandemic
An expanding patient population of diabetes mellitus population in European countries remains the key factor driving mucormycosis market in Europe, where the average diabetes prevalence rate in adults is 8.6%. Another strong factor fuelling the market growth is the favourable government initiatives that intend to boost the anti-infective drugs industry at reduced risk and manufacturing costs. The European Confederation of Medical Mycology (ECMM) has taken an initiative to develop global guideline for the diagnosis and management of mucormycosis.
On the other hand, the market in Asia Pacific is expected to grow at a rapid pace during the forecast period. Increase in prevalence of HIV and possibilities of developing effective diagnostics and treatment alternatives in untapped emerging economies are providing significant growth opportunities. India, amid the COVID-19 outbreak, is contributing ~40% to the global burden of mucormycosis infection. However, the challenge of market access will remain the key detriment to growth of the market in the Asian region. In a recent Indian study, 24.3% patients left the hospital even before getting treated, given the anticipated medical costs, potential morbidity of the surgery, and prognosis.
Key Market Players in Global Mucormycosis Market
Astellas Pharma Inc., Johnson & Johnson, Asahi Kasei Corporation, Abbott Laboratories, Biocon Limited, Novartis AG, Cadila Pharmaceuticals Limited, Merck Sharp and Dohme, F. Hoffman La Roche, Bristol Myers Squibb, Mylan Labs, Sanofi, Bayer AG, Lonza Group, Pfizer Inc., and Gilead Sciences are some of the most prominent players participating in the global mucormycosis diagnosis and treatment landscape.