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The Best Seller Of Small Molecule Drug---Apixaban
2023-01-30         

Recently, Nature Reviews Drug Discovery published an article predicting the list of TOP10 best-selling drugs in the world in 2023. Among them, Eliquis, as the leader of small molecule drugs, has attracted much attention. It is expected to become the world's best-selling small molecule drug (excluding new crown drugs) in 2023 with annual sales of US$13 billion.

 

Apixaban (Eliquis, Eliquis), also a competitive factor Xa inhibitor, was jointly developed by Bristol-Myers Squibb (BMS) and Pfizer.

Since apixaban not only prevents stroke, but also is the only anticoagulant drug that has been "head-to-head" compared with aspirin in patients who are not suitable for warfarin therapy, it is considered to reduce the incidence of stroke and prevent stroke in patients with non-valvular atrial fibrillation. Ideal for systemic thrombosis. In addition, apixaban can significantly reduce the recurrence of thrombosis and the number of deaths from any cause, and is used to prevent venous thromboembolic events (VTE) in adult patients undergoing elective hip or knee replacement.

Although both apixaban and rivaroxaban are factor Xa inhibitors, there are still some differences in the efficacy and safety of these two drugs. In a 5-year retrospective cohort study by Dr. Ghadeer K. Dawwas of the University of Pennsylvania, 49,900 eligible patients with VTE were included, of whom 18,618 were treated with apixaban and another 18,618 new users of rivaroxaban. It was found that the recurrence rate of venous thrombosis and bleeding rate were lower with apixaban than with rivaroxaban (hazard ratios, 0.77 and 0.60, respectively). This suggests that apixaban has better efficacy and safety.


Apixaban was the first to be approved for marketing in the European Union in May 2011, and was approved for marketing by the US FDA in December 2012. It is used to reduce the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation and prevent the formation of deep vein thrombosis. In 2012 It was approved for listing by PMDA in Japan in December 2013, and was approved for listing in China in January 2013, and was included in the National Medical Insurance Catalog in 2017.

As the biggest competitor of rivaroxaban, apixaban has robbed rivaroxaban of its global share once it was launched in 2012.

According to the data analysis of the PDB drug comprehensive database, the global sales of apixaban have grown steadily and continuously in recent years. The sales myth created by Varoxaban in 2018. This year, apixaban still maintains rapid growth, with sales in the first half of the year reaching US$6.446 billion, a year-on-year increase of 14%.