Avascular Necrosis Market Modest Situation Among the Top Manufacturers Bone Therapeutics, Boehringer Ingelheim, Bayer, Enzo Biochem, Ethicon, Eli Lilly, Grifols SA, Integra LifeSciences

Avascular necrosis (AVN) also termed as osteonecrosis, or aseptic necrosis, or ischemic bone necrosis, a condition resulting in the death of bone cells due to loss of blood supply. It often leads to collapse of the joint surface and subsequent arthritis due to an irregular joint surface. Avascular necrosis affects the ends (epiphysis) of long bones such as femur, upper humerus, and bones of ankle joint. Usually it develops due to combination of various factors including metabolic, genetic, increased alcohol consumption, smoking, and other diseases.

An X-ray is generally used to diagnose cause of joint pain. However, magnetic resonance imaging (MRI), is the most sensitive method for diagnosing avascular necrosis in early stages. Unlike X-rays, bone scans, and computed/computerized tomography (CT) scans, MRI detects chemical changes in bone marrow and shows avascular necrosis in its earliest stages. Nonsurgical treatment options for avascular necrosis such as anti-inflammatory medications, activity changes, and crutches can help relieve pain and slow progression of the disease. Surgical treatment include core decompression, bone and cartilage grafting, and total hip replacement. Based on the cause, avascular necrosis can be classified as traumatic and non-traumatic avascular necrosis.

According to the Science Direct Journal 2010 report, traumatic injury such as ankle sprain, fracture and joint dislocation is the most common cause of AVN, which can occur eight hours after disruption to the blood supply. Non-traumatic avascular necrosis occurs usually at young age and its causes include chronic liver disease, corticosteroids, decompression sickness, fat embolism syndrome, Gaucher disease, gout, hyperlipidaemia, haemoglobinopathy, metabolic bone disease, systemic chemotherapy systemic lupus erythematosus, and alcoholism among others.

The global avascular necrosis market size was valued at US$ 512.9 million in 2017, and is expected to witness a CAGR of 6.0% over the forecast period (2018 – 2026).

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Excessive alcohol consumption and long-term, high dose systemic corticosteroid use are the major risk factors for avascular necrosis. According to World Journal of Orthopedics, 2015, avascular necrosis usually affects people between 30 and 50 years of age. Also, from the same source, about 10,000 to 20,000 people develop osteonecrosis each year in the U.S. According to National Organization for Rare Disorders’ 2015 data, alcohol consumption and corticosteroid use affects about 30% and 35% of all people with non-traumatic avascular necrosis, respectively across the globe.

Other risk factors or conditions associated with non-traumatic osteonecrosis include autoimmune disease, cancer, decompression disease (Caisson disease), Gaucher disease, pancreatitis, HIV infection, and blood disorders such as sickle cell disease. Certain medical treatments including radiation therapy and chemotherapy can also cause osteonecrosis. Moreover, people who have undergone organ transplants are at high developmental risk of osteonecrosis. Technological advancement in therapies for avascular necrosis such as Advanced Therapy Medicinal Products (ATMPs) is expected to boost avascular necrosis market. Advanced Therapy Medicinal Products is a class of innovative therapies that comprises of gene therapy, somatic cell therapy, and tissue-engineered products.

Avascular Necrosis Market Restraints

High cost of surgical treatments and delay in diagnosis due to asymptomatic nature of this condition at early stage are the major restraining factors for avascular necrosis market growth. For instance, according to Blue Cross Blue Shield of North Carolina, a total hip replacement procedure usually cost between US$ 31,839 and US$ 44,816, with an average cost of US$ 39,299.

Avascular Necrosis Market - Regional Insights

On the basis of region, the global avascular necrosis market is segmented into North America, Latin America, Europe, Asia Pacific, Middle East, and Africa. North America is expected to generate a significant revenue share in global avascular necrosis market during the forecast period due to increasing prevalence of avascular necrosis and prior Food and Drug Administration (FDA) approval for the new avascular necrosis treatments in the region. For instance, according to National Center for Biotechnology Information (NCBI), 2015, about 20,000 to 30,000 new patients are diagnosed with avascular necrosis every year in the U.S.

Asia Pacific avascular necrosis market is expected to foresee highest growth rate during the forecast period, owing to increase in development activities for the treatment of avascular necrosis by various key players in this region. For instance, in 2017, Asahi Kasei Corporation and Bone Therapeutics signed a license agreement for the development and commercialization of PREOB in Japan. PREOB is an autologous osteoblastic cell therapy product derived from ex vivo cultured bone marrow cells of the patients.

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