Nucleoside Market: Competitive Landscape, Pipeline, and Market Analysis 2022

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A nucleoside is a molecule composed of a nucleobase (adenine, guanine, cytosine, thymine, or uracil) linked to a sugar (ribose or deoxyribose) via a glycosidic bond. It is a building block of nucleic acids like DNA and RNA. Nucleoside analogs are synthetic or modified nucleosides used as drugs that mimic natural nucleosides. They act by interfering with viral replication or DNA synthesis. Some nucleoside analogs, such as acyclovir, are used to treat viral infections like herpes, while others like azidothymidine (AZT) are used in the treatment of HIV/AIDS. According to the World Health Organization (WHO), an estimated 1.7 million people were living with HIV/AIDS in Europe, with approximately 141,000 new cases reported. In the United States, the Centers for Disease Control and Prevention (CDC) states that around 1.2 million people were living with HIV/AIDS, with about 37,968 new cases diagnosed. The prevalence of HIV/AIDS varies across countries in Europe, with Eastern Europe experiencing higher rates. In terms of herpes, the European Centre for Disease Prevention and Control (ECDC) reports that approximately 18 million people in the European Union are affected by genital herpes annually. In the United States, the CDC estimates that about one out of six people aged 14 to 49 years have genital herpes, with more women affected than men.

The growth drivers of the nucleoside stimulator market include the increasing prevalence of viral infections such as HIV and herpes, the growing demand for effective antiviral therapies, and the advancements in drug development technologies and research. Additionally, the rising awareness about the benefits of nucleoside analogs in treating viral diseases and the expanding healthcare infrastructure in developing regions contribute to the market's growth. Companies such as J&J, Merck (MSD), Fortress, SOM Biotech, PAION, Innoviva, and Viatris cater to this category. Moreover, many companies are coming up with new molecules in this space. For instance, MSD is conducting a clinical trial of the drug MK-8591 for the treatment of AIDS.

Nucleoside Market Key Developments:

In May 2022, Janssen Sciences completed the phase II PAINT trial of Rilpivirine in HIV-1 infections in USA, India, Kenya, Romania, South Africa, Thailand, Uganda and Ukraine

In March 2023, Merck Sharp & Dohme LLC preregistered Doravirine for HIV-1 infections (in children, in adults, in the elderly) in the USA

Approved Nucleoside molecules

  • Ribavirin
  • Efavirenz
  • Nevirapine
  • Tetracycline
  • Intelence (etravirine)
  • Edurant (rilpivirine)
  • Efavirenz, emtricitabine, tenofovir disoproxil fumarate
  • Tigecycline
  • Pifeltro (doravirine)
  • Tobramycin inhalation
  • Complera (emtricitabine, rilpivirine, tenofovir)
  • Dapivirine vaginal ring (dapivirine)
  • Minocycline extended release
  • Ribavirin for inhalation solution
  • Rekambys (rilpivirine LA)
  • Rescriptor (delavirdine mesylate)
  • Delstrigo (doravirine, lamivudine, tenofovir disoproxil fumarate)
  • Arikayce (amikacin liposome inhalation suspension)
  • Cabenuva (cabotegravir long acting, rilpivirine long acting)
  • Elpida (elsulfavirine)
  • Juluca (dolutegravir, rilpivirine)
  • Amzeeq (minocycline topical foam 4%)
  • Xerava (eravacycline)
  • Tobramycin Injection
  • Pegintron, Rebetol Combo Pack (peginterferon alfa-2b + ribavirin)
  • Symfi (efavirenz, lamivudine, tenofovir disoproxil fumarate)
  • TOBI Podhaler (tobramycin inhalation powder)
  • Bismuth subcitrate potassium, metronidazole, tetracycline
  • Zylet (loteprednol etabonate, tobramycin ophthalmic suspension)
  • Lamivudine, zidovudine, efavirenz
  • Minocin for injection (minocycline intravenous)
  • Odefsey (emtricitabine, rilpivirine, tenofovir alafenamide)
  • Elmiron (pentosan polysulfate sodium)
  • Rebetron (interferon α -2b , ribavirin)
  • Amikacin, fosfomycin inhalation (AFIS)
  • Duovir N (lamivudine, zidovudine, nevirapine)
  • Zilosul (pentosan polysulfate sodium)
  • Lamivudine, stavudine, nevirapine
  • Tobramycin topical
  • Biolexa (gentamicin, diethylenetriaminepentaacetic acid)
  • Meizuvo (minocycline ophthalmic ointment)

Nucleoside Pipeline Molecules

  • Islatravir (MK-8591)
  • Doravirine, islatravir (MK-8591A)
  • Sutezolid (PNU-100480)
  • TP-271
  • Depulfavirine (VM-1500A-LAI)
  • AZD5847
  • CMX157
  • PC-1005 gel
  • Arbekacin (NPC-14)
  • ADX-038
  • DuoGel (IQP-0528)
  • GS-5894
  • KM023
  • MRC375
  • RCT1100
  • TP-6076
  • Zenavod (doxycycline)
  • Adapalene, minocycline (FCD105)
  • Cabotegravir, recombinant human hyaluronidase PH20 (CAB, rHuPH20)
  • Elsulfavirine, emtricitabine, tenofovir (VM-1500FDC)
  • Linezolid suspension intradiscal (PP353)
  • Ribavirin+hydroxychloroquine (BL-8020)

Clinical Activity and Development of Nucleoside

In the Nucleoside space, more than 20 companies are conducting more than 150 clinical trials in this category of drugs. For instance,

  • In Feb 2023, Janssen Research & Development completed a phase II trial of Rilpivirine in HIV-1 infections (in children) in Thailand, Uganda, South Africa, Romania, Portugal, Italy and Spain
  • In March 2023, Merck Sharp & Dohme LLC completed a phase III trial of Doravirine in HIV-1 infections (Combination therapy, Treatment-naive) in Austria, Denmark, Germany, Italy, Portugal, Romania, Spain, United Kingdom

Product Name

Total Studies

Islatravir (MK-8591)


Doravirine, islatravir (MK-8591A)


Sutezolid (PNU-100480)




Depulfavirine (VM-1500A-LAI)






PC-1005 gel


Arbekacin (NPC-14)




DuoGel (IQP-0528)


Target Indication Analysis of Nucleoside

Nucleoside drugs target various indications related to viral infections and DNA synthesis. One of the prominent indications is the treatment of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). Nucleoside analogs like zidovudine (AZT), which inhibits viral reverse transcriptase, are used as antiretroviral therapy for HIV/AIDS patients. Another indication is the management of herpes viral infections. Nucleoside analogs such as acyclovir and valacyclovir are commonly prescribed to reduce the severity and duration of outbreaks. Additionally, nucleoside drugs play a role in the treatment of certain cancers, where they inhibit DNA replication and disrupt tumor cell growth. These drugs have demonstrated efficacy in conditions such as leukemia and pancreatic cancer, among others.

Frequently Asked Questions

The major players in this space are J&J, Merck (MSD), Fortress, SOM Biotech, AstraZeneca, Viriom, Paradigm Biopharma, Nobelpharma, ADARx, Gilead, Kainos Medicine, ReCode Therap, Persica Pharma, Pfizer, Cipla, Bausth Health.

The nucleoside drug market faces certain restraints, including the potential for drug resistance development due to the prolonged use of nucleoside analogs, which can reduce their effectiveness over time. Additionally, the high cost of nucleoside drugs and the complex manufacturing processes associated with their production can pose financial challenges and limit access to these treatments, particularly in lower-income regions.

Key Features of the Reports

  • The report provides granular level information about the market size, regional market share, historic market (2019-2023), and forecast (2024-2030)
  • The report covers in-detail insights about the competitor’s overview, company share analysis, key market developments, and their key strategies
  • The report outlines drivers, restraints, unmet needs, and trends that are currently affecting the market
  • The report tracks recent innovations, key developments, and start-up details that are actively working in the market
  • The report provides a plethora of information about market entry strategies, regulatory framework, and reimbursement scenario
  • J&J
  • Merck (MSD)
  • Fortress
  • SOM Biotech, Ewha Womans University, PAION, Innoviva
  • Viatris
  • zidovudine
  • Melinta Therap
  • Paradigm Biopharma, ReqMed, Bene-Arzneimittel
  • AstraZeneca
  • Viriom
  • Paradigm Biopharma
  • Nobelpharma
  • ADARx
  • Gilead
  • Kainos Medicine
  • ReCode Therap
  • Persica Pharma
  • Pfizer
  • Cipla
  • Bausth Health

Adjacent Markets