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시장보고서
상품코드
2082910
AL 아밀로이드증 : 시장 인사이트, 역학 및 시장 예측(2036년)AL Amyloidosis - Market Insight, Epidemiology, and Market Forecast - 2036 |
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DelveInsight
본 'AL 아밀로이드증 시장 보고서'에서는 표준 치료, 임상 실무, 진화하는 치료 알고리즘 등 현재의 치료 현황에 대한 종합적인 분석을 제공합니다. 또한, AL 아밀로이드증 환자의 부담 추이, 수익 및 시장 점유율 추이, 정점 시기의 환자 점유율 및 치료 도입 현황에 대한 분석을 평가하는 한편, 세계 각 지역 시장 규모에 대한 상세한 평가 및 성장률 전망(과거 데이터 및 2022년-2036년 전망)을 제시하고 있습니다. 본 보고서에서는 AL 아밀로이드증 분야의 주요 미충족 의료 수요에 초점을 맞추어, 경쟁 구도와 임상 현황을 분석함으로써 고부가가치의 성장 기회를 도출하고, 향후 시장 성장 가능성에 대한 명확한 전망을 제시하고 있습니다.
심장 아밀로이드증에 대한 인식 제고, 혈청 유리 경쇄 검사의 보급, 심장 바이오마커 및 첨단 영상 진단법의 활용을 통해 질환의 검출 정확도가 향상되고, 조기 개입이 촉진되고 있습니다.
시장에서는 아밀로이드 침착으로 인해 발생하는 장기 손상, 특히 심장 및 신장 조직의 손상을 직접 치료할 수 있는 치료법에 대한 관심이 높아지고 있습니다. 안셀라미맙 등 새로운 섬유소 제거 항체의 등장으로 인해, 후기 임상시험 결과에는 편차가 있음에도 불구하고, 장기 기능 회복을 목표로 하는 접근법에 대한 업계의 관심이 높아지고 있습니다.
NXC-201 등 BCMA를 표적으로 하는 CAR-T 요법과 에텐타미그를 포함한 차세대 생물학적 제제의 등장으로, 재발 또는 난치성 환자에 대한 치료 가능성이 확대되면서 형질세포 근절 전략 분야의 혁신이 촉진되고 있습니다.
AL 아밀로이드증의 개요 및 진단
전신성 아밀로이드증 중 가장 흔한 유형인 원발성 또는 경쇄(AL) 아밀로이드증은 보통 면역글로불린에 결합되어 있는 유리 경쇄가 클론성 또는 명백히 악성인 형질세포에 의해 과도하게 생성됨으로써 발병합니다. AL 아밀로이드증은 암으로 간주되지는 않지만, 다발성 골수종과 몇 가지 유사한 특징 및 치료법을 공유하고 있습니다. AL 아밀로이드증은 일반적으로 환자의 골수 내 형질세포 비율이 10% 미만일 때 진단됩니다(이는 골수종 진단에 필요한 수치입니다). 그러나 진행된 다발성 골수종, 비호지킨 림프종, 발덴스트룀 거대글로불린혈증, 만성 림프구성 백혈병, 쇼그렌 증후군, 베체트병과 동반될 수도 있습니다.
전신성 AL 아밀로이드증의 진단은 혈청 및 소변의 면역고정법, 혈청 유리 경쇄 검사, 24시간 소변 단백질 측정을 통해 단일 클론성 단백질을 검출하는 것에서 시작됩니다. 이상 소견이 확인된 경우, 아밀로이드 침착을 확인하기 위해 콩고레드 염색을 이용한 조직 생검이 시행되며, 장기 바이오마커 및 영상 검사는 장기 병변 평가에 도움이 됩니다. 복부 지방 조직 및 골수 생검은 일반적으로 대체 검사 부위로 사용되며, 그 종합 감도는 약 85%이지만, 의심스러운 사례에서는 여전히 장기 생검이 필요할 수 있습니다. 확정 진단 후에는 AL 아밀로이드증을 ATTR 아밀로이드증 등 다른 아밀로이드 아형과 구별하기 위해, 가능하면 질량 분석법에 기반한 단백질체학를 활용한 정확한 아밀로이드 유형 분류가 필수적입니다.
AL 아밀로이드증의 현재 치료 현황
AL 아밀로이드증의 치료는 주로 아밀로이드원성 경쇄를 생성하는 클론성 형질세포를 제거하는 데 중점을 둡니다. 현재 표준 1차 치료법은 다라줌맙(DARZALEX)과 보르테조미브, 시클로포스파미드, 덱사메타손을 병용하는 'Dara-VCd'이며, 이 치료법은 신규 진단 환자에서 높은 혈액학적 및 장기 반응률을 보이고 있습니다. 장기 기능이 유지되고 있는 적격 환자에게는 ASCT가 시행되는 경우가 있습니다. 심장, 신장 및 기타 장기와 관련된 합병증을 관리하는 데 있어서는 여전히 지지 요법이 필수적입니다. 재발 또는 난치성 사례에서는 레날리도마이드, 포마리도마이드 및 프로테아좀 억제제를 기반으로 한 반복 요법 등이 일반적으로 사용되고 있습니다. 질병을 보다 깊이 있고 지속 가능하게 관리하기 위해, 새로운 단일클론 항체, 이중 특이성 항체, BCMA를 표적으로 하는 CAR-T 세포 치료법 등 새로운 치료 접근법이 연구되고 있습니다.
AL 아밀로이드증의 역학 분석 및 예측에 관한 주요 연구 결과
AL 아밀로이드증 치료 시장은 큰 변혁기를 맞이하고 있으며, 기존의 형질세포를 표적으로 한 치료법에서 장기를 표적으로 한 치료 및 질환 수정 요법으로 진화하고 있습니다. 그동안 치료는 보르테조미브 등의 프로테아좀 억제제, 시클로포스파미드 등의 알킬화제, 코르티코스테로이드, 그리고 적격 환자를 대상으로 한 자가 조혈모세포 이식 등, 다발성 골수종 치료법을 응용한 방법이 주류를 이루었습니다. 달라줌맙 및 히알루로니다제 -fihj(DARZALEX)와 CyBorD의 병용 요법이 승인됨에 따라, 새로 진단된 AL 아밀로이드증에 특화된 FDA 승인 최초이자 유일한 표준 치료 요법이 확립되었으며, 혈액학적 반응률이 대폭 향상됨과 동시에 1차 치료에서 CD38 표적 요법의 도입이 가속화되었습니다. 그러나 클론성 형질세포의 억제 분야에서 진전이 있었음에도 불구하고, 지속적인 장기 기능 장애, 진행성 심장 질환에서 나타나는 높은 조기 사망률, 그리고 재발성 및 난치성 환자에 대한 치료 선택지의 제한으로 인해 여전히 해결되지 않은 의료적 요구가 많이 남아 있습니다.
현재 개발 중인 파이프라인은 장기 표적 항체, 생물학적 제제 및 CAR-T 세포 치료법을 통해 차별화가 점점 더 심화되고 있습니다. 아스트라제네카의 안셀라미맙은 아밀로이드 섬유를 제거하는 단일클론 항체로 개발되었으며, AL 아밀로이드증 치료에 있어 가장 진보된 장기 표적 치료법 중 하나였습니다. 그러나 이 치료법은 두 건의 제3상 CARES 임상시험에서 전체 사망률을 통계적으로 유의미하게 감소시키지 못했기 때문에 주요 평가 지표를 달성하지 못했습니다. 이러한 좌절에도 불구하고, 하위군 분석 결과 특정 환자 집단에서 임상적으로 유의미한 효과가 확인되었으며, 아스트라제네카는 규제 당국과의 협의 및 승인 신청을 계속 진행하고 있습니다.
이와 동시에, 애비(AbbVie)사의 에텐타미그는 아밀로이드 원성 경쇄의 억제를 개선하고 혈액학적 반응의 지속성을 높이기 위해 설계된 차세대 형질세포 표적 치료법에 대한 관심이 높아지고 있음을 여실히 보여주고 있습니다. 또한, 이믹스 바이오파마의 'NXC-201'은 재발성·난치성 AL 아밀로이드증에서 BCMA 표적 CAR-T 요법의 역할을 한 단계 발전시키고 있으며, 다제내성 환자에서 깊고 지속적인 질병 통제를 달성하기 위한 세포 면역 요법의 확대 가능성을 입증하고 있습니다.
전반적으로, 아밀로이드 제거 항체 개발에서 최근 임상적 난항이 있었음에도 불구하고, 표적 생물학적 제제 및 세포 치료 분야의 지속적인 혁신을 통해 주요 7개국에서 AL 아밀로이드증의 치료 환경이 새롭게 재편되고, 보다 개인 맞춤형이며 장기에 초점을 맞춘 치료 전략으로의 전환이 가속화될 것으로 예측됩니다.
현재 AL 아밀로이드증의 일반의약품 시장에서는 단일클론 항체를 기반으로 한 형질세포 요법이 주류를 이루고 있지만, 아밀로이드 섬유를 표적으로 하는 항체, 이중 특이성 항체, 그리고 BCMA를 표적으로 하는 CAR-T 요법이 개발 파이프라인의 혁신을 주도하며 미래 치료의 방향을 형성하고 있습니다.
DelveInsight's 'AL Amyloidosis- Market Insights, Epidemiology and Market Forecast - 2036' report delivers an in-depth understanding of the AL amyloidosis, historical and forecasted epidemiology, as well as the AL amyloidosis market trends in the United States, EU4 (Germany, Spain, Italy, and France) and the United Kingdom, and Japan.
The AL Amyloidosis market report delivers a comprehensive analysis of the current treatment landscape, including standards of care, clinical practices, and evolving therapeutic algorithms. It evaluates, AL amyloidosis patient burden trends, revenue & market share dynamics, peak patient share & therapy uptake analysis, and provides an in-depth market size assessment, and growth rate projections (Historical & Forecast 2022-2036) across global regions. The report highlights key unmet medical needs in AL amyloidosis and maps the competitive and clinical landscape to uncover high-value opportunities, providing a clear outlook on future market growth potential.
Key Factors Driving the AL Amyloidosis Market
Increasing recognition of cardiac amyloidosis, wider use of serum free light-chain testing, cardiac biomarkers, and advanced imaging modalities are improving disease detection and supporting earlier intervention.
The market is witnessing strong interest in therapies capable of directly addressing organ damage caused by amyloid deposition, particularly in cardiac and renal tissues. Emerging fibril-clearing antibodies such as anselamimab have reinforced industry focus on organ-restorative approaches despite mixed late-stage clinical outcomes.
The emergence of BCMA-targeted CAR-T therapies such as NXC-201 and next-generation biologics including etentamig is expanding treatment possibilities for relapsed or refractory patients and driving innovation in plasma cell eradication strategies.
AL Amyloidosis Overview and Diagnosis
Primary or light chain (AL) amyloidosis, the most common type of systemic amyloidosis, occurs when the free light chains normally associated with immunoglobulins are produced in excess by clonal or frankly malignant plasma cells. Although AL amyloidosis is not considered a cancer, it shares some similar characteristics and treatments with multiple myeloma. AL amyloidosis is most commonly diagnosed when the affected patient has less than 10% bone marrow plasma cells, the quantity required to make a diagnosis of myeloma, but may also occur in association with full-blown multiple myeloma, non-Hodgkin's lymphoma, Waldenstrom's macroglobulinemia, chronic lymphocytic leukemia, Sjogren's syndrome, and Behcet syndrome.
Diagnosis of systemic AL amyloidosis begins with detection of monoclonal proteins using serum and urine immunofixation, serum free light chain testing, and 24-hour urine protein assessment. If abnormalities are identified, tissue biopsy with Congo red staining is performed to confirm amyloid deposition, while organ biomarkers and imaging help evaluate organ involvement. Abdominal fat pad and bone marrow biopsies are commonly used surrogate sites, with combined sensitivity of ~85%, although organ biopsy may still be required in suspected cases. Following confirmation, accurate amyloid typing, preferably through mass spectrometry-based proteomics is essential to distinguish AL amyloidosis from other amyloid subtypes such as ATTR amyloidosis.
Current AL Amyloidosis Treatment Landscape
Treatment of AL amyloidosis primarily focuses on eliminating the clonal plasma cells responsible for producing amyloidogenic light chains. The current standard frontline regimen is daratumumab (DARZALEX) combined with bortezomib, cyclophosphamide, and dexamethasone (Dara-VCd), which has demonstrated strong hematologic and organ response rates in newly diagnosed patients. Eligible patients with preserved organ function may undergo ASCT. Supportive care remains essential for managing cardiac, renal, and other organ-related complications. In relapsed or refractory disease, therapies such as lenalidomide, pomalidomide, and repeat proteasome inhibitor-based regimens are commonly used. Emerging treatment approaches, including novel monoclonal antibodies, bispecific antibodies, and BCMA-targeted CAR-T cell therapies, are being investigated to achieve deeper and more durable disease control.
AL Amyloidosis Unmet Needs
The section "unmet needs of AL amyloidosis" outlines the critical gaps between the current state of patient care, diagnosis, and the ideal & effective management of the disease. It highlights the obstacles experienced by patients, clinicians, and researchers and identifies potential solutions for future progress.
Key Findings from AL Amyloidosis Epidemiological Analysis and Forecast
AL Amyloidosis Drug Analysis & Competitive Landscape
The AL amyloidosis drug chapter provides a detailed, market-focused review of approved therapies and the emerging pipeline across Phase I-III clinical trials. It covers mechanism of action, clinical trial data, regulatory approvals, patents, collaborations, strategic partnerships, upcoming key catalyst for each therapy, along with their advantages, limitations, and recent developments. This section offers critical insights into the AL amyloidosis treatment landscape, supporting market assessment, competitive analysis, and growth forecasting for the AL amyloidosis therapeutics market.
Approved Therapies for AL Amyloidosis
Daratumumab and hyaluronidase-fihj (DARZALEX FASPRO): Johnson & Johnson
Daratumumab and hyaluronidase-fihj is the only CD38-directed antibody approved to be given subcutaneously to treat patients with multiple myeloma and now AL amyloidosis. It is co-formulated with recombinant human hyaluronidase PH20 (rHuPH20), Halozyme's ENHANZE drug delivery technology.
In January 2021, Daratumumab and hyaluronidase-fihj got accelerated approval from the US Food and Drug Administration (FDA) for the treatment of adult patients with newly diagnosed AL amyloidosis. On November 19, 2025, the FDA granted traditional approval to daratumumab and hyaluronidase-fihj
AL Amyloidosis Pipeline Analysis
Anselamimab: AstraZeneca
Anselamimab is an investigational, potentially first-in-class anti-fibril monoclonal antibody designed to improve organ function by reducing or eliminating amyloid deposits in the tissues and organs of patients living with AL amyloidosis. By binding with specificity to targets within amino acids on misfolded amyloid fibrils, anselamimab promotes destruction and clearance of amyloid deposits, while sparing native free light chains from destruction. It has been granted Fast Track Designation and by the US Food and Drug Administration (FDA) and received Orphan Drug Designation (ODD) from the US FDA, European Commission and the Ministry of Health, Labour and Welfare of Japan for the treatment of AL amyloidosis.
As per the AstraZeneca's 2026 corporate presentation, the company anticipates first regulatory decision for anselamimab in AL amyloidosis in H2 2026.
Etentamig: AbbVie/Amgen
Etentamig is an investigational therapy from AbbVie being developed for AL amyloidosis, a rare plasma cell disorder marked by misfolded light-chain protein deposition in organs. It is designed to target and reduce pathogenic plasma cell activity, aiming to lower amyloidogenic light chains and slow multi-organ damage progression, addressing a high unmet need for more effective and durable disease control. The drug is currenltly being evaluted in a Phase II clinical trial for AL amyloidosis.
AL Amyloidosis Key Players, Market Leaders and Emerging Companies
AL Amyloidosis Drug Updates
The AL amyloidosis treatment market is undergoing a significant transformation, evolving beyond traditional plasma cell-directed regimens toward organ-targeted and disease-modifying therapeutic strategies. Historically, treatment has relied on adapted multiple myeloma therapies, including proteasome inhibitors such as bortezomib, alkylating agents like cyclophosphamide, corticosteroids, and autologous stem cell transplantation in eligible patients. The approval of daratumumab and hyaluronidase-fihj (DARZALEX) in combination with CyBorD established the first and only FDA approved standard of care regimen specifically for newly diagnosed AL amyloidosis, significantly improving hematologic response rates and accelerating adoption of CD38-targeted therapy across frontline settings. However, despite advances in clonal plasma cell suppression, substantial unmet need remains due to persistent organ dysfunction, high early mortality in advanced cardiac disease, and limited options for relapsed or refractory patients.
The emerging pipeline is increasingly differentiated by organ-targeted antibodies, biologics, and CAR-T cell therapies. Anselamimab from AstraZeneca, developed as an amyloid fibril-clearing monoclonal antibody, represented one of the most advanced organ-directed approaches in AL amyloidosis. However, the therapy failed to meet the primary endpoint in two Phase III CARES studies by not demonstrating a statistically significant reduction in overall mortality. Despite this setback, subgroup analyses showed clinically meaningful benefit in selected patient populations, prompting AstraZeneca to continue pursuing regulatory discussions and submissions.
In parallel, Etentamig from AbbVie highlights the growing focus on next-generation plasma cell-targeted therapies designed to improve suppression of amyloidogenic light chains and enhance durability of hematologic responses. Additionally, NXC-201 from Immix Biopharma is advancing the role of BCMA-targeted CAR-T therapy in r/r AL amyloidosis, reinforcing the expanding potential of cellular immunotherapy to achieve deep and sustained disease control in heavily pretreated patients.
Overall, despite recent clinical setbacks in amyloid-clearing antibody development, continued innovation across targeted biologics and cell therapies is expected to reshape the AL amyloidosis landscape in the 7MM, driving a transition toward more personalized and organ-focused therapeutic strategies.
Drug Class/Insights into Leading Emerging and Marketed Therapies in AL Amyloidosis (2022-2036 Forecast)
The AL amyloidosis market comprises monoclonal antibodies, bispecific antibodies, and emerging CAR-T cell therapies designed to suppress pathogenic plasma cells, reduce amyloidogenic light-chain production, and address progressive organ dysfunction associated with the disease.
Currently, monoclonal antibody-based plasma cell therapies dominate the commercial AL amyloidosis market, while amyloid fibril-targeting antibodies, bispecific antibodies, and BCMA-directed CAR-T therapies are driving pipeline innovation and shaping the future treatment landscape.
AL Amyloidosis Drug Uptake
This section focuses on the uptake rate of potential drugs expected to be launched in the market during the forecast period (2026-2036). The analysis covers the AL amyloidosis drug's uptake, performance at peak, factors affecting performance during prime years of growth, patient uptake by therapy, and anticipated sales generated by each drug.
The uptake of therapies in the AL amyloidosis market is expected to be driven by clinical efficacy in achieving rapid hematologic response, organ function improvement, durability of remission, and applicability in relapsed or high-risk patient populations. Established daratumumab (DARZALEX)-based regimens are anticipated to maintain fast uptake due to their established frontline positioning and widespread physician familiarity. Emerging therapies such as anselamimab may experience moderate and selective adoption following mixed Phase III outcomes, although interest in amyloid-clearing approaches remains strong due to the unmet need for organ-restorative therapies. Meanwhile, innovative immune-based therapies including etentamig and NXC-201 are expected to witness gradual uptake in relapsed or refractory settings, supported by their potential for deeper and more durable disease control, while adoption may initially remain concentrated in specialized treatment centers due to cost and administration complexity.
Detailed insights of emerging therapies' drug uptake is included in the report
Market Access and Reimbursement of Approved therapies in AL Amyloidosis
The report further provides detailed insights on the country-wise accessibility and reimbursement scenarios, cost-effectiveness scenario of approved therapies, programs making accessibility easier and out-of-pocket costs more affordable, insights on patients insured under federal or state government prescription drug programs, etc.
AL Amyloidosis Therapies Price Scenario & Trends
Pricing and analogue assessment of AL amyloidosis therapies highlights evolving price dynamics structures. This section summarizes the cost of approved treatments, closest and most appropriate analogue selection for emerging therapies, and understanding of how pricing influences market access, adherence, and long-term uptake.
Industry Experts and Physician Views for AL Amyloidosis
To keep up with AL amyloidosis market trends, we take Key Opinion Leaders (KOLs) and Subject Matter Experts (SMEs) opinions working in the domain through primary research to fill the data gaps and validate our secondary research. Industry experts were contacted for insights on the AL amyloidosis emerging therapies, evolving treatment landscape, patient adherence to conventional therapies, therapy switching trends, drug adoption and uptake, accessibility challenges, and epidemiology and real-world prescription patterns in AL amyloidosis, including MD, PhD, Instructor, Postdoctoral Researcher, Professor, Researcher, and others.
DelveInsight's analysts connected with 15+ KOLs to gather insights at country level. Centers such as the Washington University School of Medicine, University Medical Center Hamburg-Eppendorf, and University Graduate School of Medicine, etc. were contacted.Their opinion helps understand and validate current and emerging AL amyloidosis therapies, highlight unmet medical needs, provide epidemiological context, and support strategic decisions for market access, therapy adoption, and pipeline prioritization in AL amyloidosis.
Qualitative Analysis: SWOT and Conjoint Analysis
We perform qualitative and market Intelligence analysis using various approaches, such as SWOT analysis and conjoint analysis.
In the SWOT analysis of AL amyloidosis, strengths, weaknesses, opportunities, and threats in terms of disease diagnosis, patient awareness, patient burden, competitive landscape, cost-effectiveness, and geographical accessibility of therapies are provided.
Conjoint analysis analyzes emerging therapies based on relevant attributes such as safety, efficacy, frequency of administration, route of administration, and order of entry. Scoring is given based on these parameters to analyze the effectiveness of therapy.
The team of analysts analyzes promising emerging therapies based on relevant attributes such as safety, efficacy, frequency of administration, route of administration, and order of entry. In efficacy, the trial's primary and secondary outcome measures are evaluated, whereas the therapies' safety is evaluated, wherein the acceptability, tolerability, and adverse events are majorly observed. In addition, the scoring is also based on the route of administration, order of entry, probability of success, and the addressable patient pool for each therapy. According to these parameters, the final weightage score and the ranking of the emerging therapies are decided.
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