Acute Respiratory Distress Syndrome: Introduction, Causes,

Symptoms, Epidemiology, Market, Treatment and market size

Acute Respiratory Distress Syndrome or ARDS, an acute diffuse, inflammatory lung
damage and injury, which leads to raised pulmonary vascular permeability,
increased lung weight, and loss of aerated lung tissue with hypoxemia and bilateral
radiographic opacities, associated with increased venous admixture, increased
physiological dead space and decreased lung compliance.

ARDS Causes

The leading cause of the disease is when the fluid is exuded from the blood vessels
into the small air sacs where the blood is oxygenated. The most common
underlying causes of ARDS are:

 Sepsis. The most common cause is sepsis, which is a severe infection of the
bloodstream.
 Inhalation of harmful substances. If high concentrations of smoke or chemical
fumes are inhaled in the, it can result in ARDS.
 Severe pneumonia. Severe cases of pneumonia affect all five lobes of the
lungs.
 Head, chest or another significant injury. Accidents like falls or car crashes
can squarely damage the lungs or the portion of the brain that controls
breathing.
 Others. Pancreatitis, massive blood transfusions and burns.

ARDS Symptoms

ARDS symptoms can differ in intensity, depending on its cause and severity, as well
as the presence of underlying heart or lung disease. These are severe shortness of
breath, laboured and unusually rapid breathing, low blood pressure, confusion and
extreme tiredness.

ARDS Epidemiology

Many people are affected as there were total 815,490 Acute Respiratory Distress
Syndrome incident cases in the 7MM in 2017. The United States accounts for the
highest Acute Respiratory Distress Syndrome incident cases with 497,947 cases in
2017. The overall incidence of moderate ARDS was maximum in the US with
232,044 cases in 2017, followed by mild and severe and is subjected to increase
rapidly in the coming years. Among the EU5 countries, Germany had the highest
incident population of ARDS with 148,302 cases, followed by Italy, which had the
incident population of 44,700 in 2017 whereas, Spain had the lowest incident
population of 20,839 in 2017.

ARDS Market

As many people are affected by the disease due to which the global burden of ARDS
has increased over the years. Among the seven major markets, the United States
has reported maximum incident cases of ARDS. The therapeutic Acute Respiratory
Distress Syndrome market in the seven major markets was USD 787.1 Million in
2017.
The United States holds the highest ARDS market share of 2017 with USD 490.75
million. Among EU5 countries, Germany has the largest Acute Respiratory Distress
Syndrome market size with USD 136.41 million in 2017, while Spain has the smallest
ARDS market size, with USD 19.17 million in 2027.

ARDS treatment

Acute Respiratory Distress Syndrome treatment is mainly supportive, which

includes invasive mechanical ventilation with lung protective strategies. However,
long-term intubation may carry a high rate of complications, including ventilator-
associated pneumonia, delirium and critical illness myopathy and neuropathy.
Noninvasive ventilation (NIV) and the application of continuous positive airway
pressure (CPAP) is contemplated in mild ARDS, although its use in acute hypoxemic
respiratory failure remains controversial and the choice of the interface device is
still debated.

Other ARDS treatment options, which the patients with ARDS are generally
subjected to, include supplemental oxygen, prone positioning, use of people with
paralysis, fluid management and a technique called positive end-expiratory
pressure (PEEP) to push the fluid out of air sacs. These are in combination with
persistent treatment of the original illness. Antibiotics are given to people to fight
infection. Also, supportive treatment, such as intravenous fluid or food, may be
needed. Further, the use of adjunctive treatments in patients with ARDS on day 1
or 2 was relatively low but increased with ARDS severity. Continuous
neuromuscular blocking agents, high-dose steroids, and recruitment manoeuvres
are the most frequently used adjuncts.

Several methods for pharmacological intervention have been evaluated in patients

with ARDS, but most of them failed to decrease mortality or improve outcomes
despite some promising observations seen in preclinical studies. Prior methods
such as nitric oxide inhalation, neuromuscular blocking agents and corticosteroids
may still have a place in the treatment, while novel therapeutic approaches
comprising the use of angiotensin-converting enzyme inhibitors, statins and stem
cells are currently under investigation and are prescribed as off-label treatment
regimens. Despite recent advances in critical care, the mortality due to ARDS varies
significantly. Thus, as ARDS is progressing at a breakneck pace, therefore there is
an immediate need to have approved therapies for ARDS treatment. It is
anticipated that the ARDS market size of the currently available supportive
therapies for the treatment shall experience steady growth throughout the study
period [2016-2027], in the US. However, the emerging therapies targeted for ARDS
are expected to fuel the growth of the market.

ARDS Market Size by Therapies

The dynamics of ARDS market is anticipated to change during the forecast period
due to the expected launch of emerging therapies during the forecast period of
2019-2028. The leading players in the ARDS market are Faron Pharmaceuticals,
Implicit Bioscience, Techpool Bio-Pharma, BioMarck Pharmaceuticals, Athersys,
Apeptico Forschung und Entwicklung GmbH, Savara, Cynata Therapeutics, and
others. Two upcoming therapies in the late clinical development, are aimed at
ARDS treatment and hence are anticipated to make a significant impact on ARDS
market size. These include Traumakine (Faron Pharmaceuticals) and BIO- 11006
(BioMarck Pharmaceuticals) and are expected to launch during the forecast period
[2018-2027].