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Cardiovascular
Disease
Thrombosis is the formation
or presence of a blood clot inside
a blood vessel or cavity of the
heart. The formation of a blood
clot is induced by the clumping
of blood platelets followed by the formation of a fibrin network.
The main diseases which are caused by thrombosis are described below.
Stroke
Stroke is caused by a blockage or a rupture of the arteries of the brain,
which deprives the brain of oxygen causing severe neurological damage and death.
Stroke is the third most frequent cause of death in the western world. It is
estimated that over 2 million people suffer a stroke annually. Mortality is
high with 20 per cent of patients dying, whilst the majority of the remainder
is left permanently disabled.
According to the American Heart Association, the estimated direct and indirect cost of stroke in 2007 was $62.7 billion. Drug expenditure was estimated at approximately
$1.0 billion. The USA National Stroke Association has estimated that the average
cost per patient for the first 90 days of treatment ranges from $15,000 to
$35,000. Thus, medication that improves patient outcome and reduces the need
for rehabilitation could bring a net benefit to the healthcare system.
Deep Vein Thrombosis (DVT)
Deep vein thrombosis (DVT) is due to low blood flow conditions, usually in
the deep veins of the leg or pelvis. DVT is a problem associated with immobility.
DVT occurs in 40-80 per cent of patients who undergo total knee replacement
and do not receive proper rehabilitation. DVT affects approximately 0.2 per
cent of the population, mostly adults aged over 60.
The detachment of a DVT can lead to a pulmonary embolism whereby the clot detaches
and blocks the blood flow to the lungs. In the USA, pulmonary embolism is the
third most common cause of death, with at least 650,000 cases annually.
VTE (Venous thromboembolism) is used to refer collectively to DVT and pulmonary
embolism.
Peripheral arterial occlusive disease (PAOD)
PAOD refers to the partial or complete obstruction of a peripheral artery,
usually in the leg, that restricts normal blood flow. According to the American
Heart Association, PAOD affects an estimated 27 million individuals in the
USA and Europe. PAOD is associated with significant morbidity and mortality.
Acute myocardial infarction (AMI)
The National Heart, Lung, and Blood Institute estimates that 1.1 million Americans
suffer from AMI (heart attack) each year, of which nearly half are fatal.
Coronary artery disease (CAD)/Acute coronary syndrome (ACS)
CAD is caused by the build-up of a plaque on the wall of a coronary artery.
A blood clot (thrombosis) can form on the plaque blocking the blood flow, which
results in a condition called acute coronary syndrome (ACS). If the blood clot
blocks blood flow completely, this leads to an AMI (heart attack). CAD afflicts
13.2 million Americans and is the leading cause of mortality in the cardiovascular
disease category.
Atrial fibrillation (AF)
AF is caused by uncoordinated contraction of the upper chambers of the heart,
that could lead to the formation of a clot, which may travel to the brain and
cause an ischemic stroke. According to the American Heart Association about
15 per cent of strokes occur in people with AF. Around 2.2 million patients
suffer from AF in the USA, resulting in over 40,000 deaths per annum.
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Eye
Disease
 ThromboGenics is focused on diseases which occur at the back of the eye including
diabetic retinopathy and age-related macular degeneration. These disorders are
difficult to treat because of the location of the diseased tissue and the limited
understanding of the disease, leading to significant morbidity including blindness.
Diabetic
retinopathy (DR)
Diabetic retinopathy is a complication of diabetes and a leading cause of blindness.
It occurs when diabetes damages the tiny blood vessels inside the retina, the
light-sensitive tissue at the back of the eye. DR is the most common cause of
blindness in people of working-age in most westernised societies. Approximately
20.8 million Americans have diabetes, with approximately 40 per cent of these
patients having some evidence of diabetic retinopathy.
The most common treatment for DR is laser surgery. However, if the bleeding is
severe (e.g. in the case of a vitreous hemorrhage), a surgical procedure, called
a vitrectomy may be needed. Vitrectomy is the surgical removal of diseased “vitreous” (gel-like
substance in the center of the eye) from the retina; this procedure is performed
to induce a posterior vitreous detachment. In the USA, an estimated 250,000 procedures
are performed annually. On a global basis, it is estimated that 600,000 vitrectomies
take place annually.
Age-related
macular degeneration (AMD)
Age-related macular degeneration is a degenerative condition of the macula (central
retina). It is the most common cause of vision loss in the age group 50 or older,
with the disease affecting approximately 15 million Americans.
Currently, the most common treatment options include laser photocoagulation and
photodynamic therapy (PDT). Recently new Anti-VEGF therapies to treat AMD have
begun to enter the market.
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Cancer
 Cancer is a leading cause of death globally and the second leading cause of death
in the developed world after cardiovascular diseases. The World Health Organization
(WHO) estimates that more than 11 million people are diagnosed with cancer each
year, and according to the American Cancer Society, there were 1.4 million new
cases in 2007 in the United States alone.
All cancers are characterised by abnormal or uncontrolled cell division and proliferation.
Conventional treatments for cancer include surgery, radiotherapy, hormone therapy
and chemotherapy. Despite major advances in understanding of the molecular basis
of cancer, few treatments have been developed to specifically target tumor cells.
One class of cancer therapeutics with particular promise is inhibitors of angiogenesis.
Angiogenesis inhibitors work by preventing the growth of the vasculature in tumors,
limiting the supply of oxygen and nutrients required for the tumor to grow. When
combined with other drugs, these compounds have also been shown to be effective
methods of treating certain types of cancer, e.g. colorectal cancer. Avastin
from Genentech is currently the only anti-angiogenic compound on the market, with
sales of $2.3 billion in 2007.
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 All rights reserved © Thrombogenic 2006 Last update:
June 25, 2008
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