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Bone and mineral metabolism disorder is a collective term used to describe various conditions that make bones weak. Bone mineral metabolism maintains sufficient concentration of inorganic ions in blood serum.
Progressive chronic kidney disease, especially end-stage renal disease (ESRD), is responsible for adverse changes in bone and mineral metabolism. Increase in serum parathyroid hormone levels due to fall in glomerular filtration rate is an indicator of bone disorder caused by chronic kidney disease.Reduction in kidney function leads to changes in bone mineral homeostasis and in levels of parathyroid hormone (PTH), 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, and fibroblast growth factor-23 (FGF-23). Disorders of mineral metabolism in chronic kidney disease (CKD) have been associated with higher mortality than anemia and inadequate dialysis.
Increased prevalence of chronic kidney diseases, rising geriatric population, and changing lifestyles which lead to mineral and hormonal disturbances drive the bone and mineral metabolism disorders treatment market. However, high cost of the treatment and side effects of the medications hamper market growth.
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The bone and mineral metabolism disorders treatment market can be segmented based on type of disorder, type of medication used to prevent and treat bone and mineral disorders, and region. In terms of type of disorder, the market can be classified into osteoporosis, osteomalacia, rickets, osteitis fibrosa cystica, adynamic bone disease, vascular calcification, and Pagets disease.
Osteoporosis and vascular calcification are highly prevalent among the CKD population and are progressing rapidly. Medications are segmented based on type of disorder to be treated.
For instance, treatment of osteoporosis involves prevention of fractures. Hence, the osteoporosis medications segment can be classified into drugs and nutrients used for primary prevention of fractures including calcium and vitamin D supplements, and hip protectors and hip pads to avoid hip damage due to fall.
Drugs utilized to treat osteoporosis are categorized into antiresorptive drugs (to reduce bone loss) and anabolic agents (to build bone). Major chemical classes under antiresorptive drugs are bisphosphonates, estrogen, selective estrogen receptor modulators (SERMs), biological, and calcitonin.
In 2010, the FDA approved monoclonal antibody named Denosumab for the treatment of postmenopausal women who are at high risk of fractures. Teriparatide is a synthetic form of parathyroid hormone and is the only FDA-approved anabolic.
Phosphate binding agents and dialysis are used in the treatment of hyperphosphatemia. There are three types of phosphate binders: calcium based binders, non-calcium based binders, non-metal based binders, and metal-based binders.
Aluminum and magnesium-based binders. Vitamin D analog is indicated in the management of hypocalcemia in patients undergoing chronic renal dialysis.
Management of secondary hyperparathyroidism in patients not yet on dialysis is done with calcitriol capsules and oral solution. Calcimimetic agent (cinacalcet) is indicated for the treatment of secondary hyperparathyroidism in patients with CKD on dialysis and for the treatment of hypercalcemia in patients with parathyroid carcinoma.
Apart from these disease specific agents, pain managing medications and several types of surgeries are driving the market.
In terms of region, the bone and mineral metabolism disorders treatment market can be segmented into North America, Latin America, Europe, Asia Pacific, and Middle East & Africa. North America is leading the global market.
Several collaborative efforts taken by major companies to enhance their research outcomes in this area, world-class diagnosis facilities, increased awareness about disorders, rising geriatric population, and growing obese population are drivers of the bone and mineral metabolism disorder treatment market in North America. Europe is witnessing strong growth due to increasing geriatric population and higher incidence of disorders in postmenopausal women.
Moreover, the market in Asia Pacific is expected to witness significant growth during the forecast period due to increasing incidence of the disorder, negligence of diet and lack of nutrition, and introduction of advanced diagnosis technologies.
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Key players operating in the bone and mineral metabolism disorder treatment market are Eli Lilly and Company, F. Hoffmann-La Roche, Pfizer, Inc., Actavis plc, Teva Pharmaceutical Industries Ltd., Novo Nordisk A/S, Amgen, Inc., Merck & Co., Inc., and Novartis International AG.
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