Higher profile yet to lead to better treatment for Parkinson’s

The respective plights of celebrities like former heavyweight boxer and civil rights activist Muhammad Ali and actor Michael J Fox have helped bring the devastating and debilitating effects of Parkinson’s disease (PD) more into the public consciousness. However despite the increased publicity and funding these two prominent sufferers have brought to Parkinson’s research, a recent report by independent market analyst Datamonitor* reveals that there is still a major need for drugs that can even effectively delay the disease’s progression for the 1.3 million Parkinson’s sufferers globally**.

Need for better drugs

Currently marketed therapies work primarily to treat the symptoms of Parkinson’s, Datamonitor central nervous system analyst Emma Travis says. “Drugs that can effectively delay, halt or ideally reverse the progression of Parkinson’s are the major unmet need in this area. Unfortunately those drugs that are currently on the market do not fill this void.   On the bright side, several compounds in development have been shown to demonstrate potentially neuroprotective properties. Unfortunately huge challenges remain for these compounds to reach the market and provide convincing clinical evidence of their effectiveness.”

The most effective therapy currently available for Parkinson’s is levodopa, which undeniably remains the cornerstone of Parkinson’s treatment, if not the gold standard, Travis says. “Nevertheless, the effectiveness of levodopa tends to diminish over time, and patients often begin to experience a re-emergence of symptoms like uncontrollable trembling before their next dose.    Sixty to 80% of PD patients on levodopa experience response fluctuations after two to five years of therapy.”

Newer therapies have helped to address this problem somewhat, but rather than representing an alternative improved treatment to that offered by levodopa therapy, the newer treatments have generally only been considered add-on therapies, Travis says. “The aim of these newer treatments is to prolong the clinical effectiveness of the levodopa therapy. This has meant that the PD market has seen only moderate growth as newer therapies were only utilized in the latter stages of the disease, which in turn discourages further investment in the market by pharmaceutical companies.” 

Aging population means more patients

However this may change because the aging population is increasing the number of potential Parkinson’s patients, Travis says. “PD is primarily a disease of elderly individuals with a peak age at onset of 55 to 66, with an estimated prevalence rate of 100-200/100,000 population. However global demographic changes mean that the incidence of PD is set to increase as the number of elderly worldwide rises along with life expectancy.”

Furthermore, the American Parkinson’s Disease Association has reported that there is an alarming increase in patients of a younger age, Travis says.

“This is an impression echoed by the majority of opinion leaders interviewed by Datamonitor. However, they believe this may not be a real increase but rather the outcome of improvements in diagnosis and referral pattern.  Nevertheless, the absolute number of patients being treated is forecast to grow, meaning the PD market will become more attractive to investors.”

Diagnosis is not always easy with Parkinson’s, Travis says. “In some patients it is made easier by the presentation of the classic signs of Parkinson’s: trembling at rest, slowed movements and stiffness on only one side of the body. Making an accurate diagnosis in the early stages of the disease is a key to slowing its progress, however doing so can be difficult even for an experienced neurologist.”

No major improvements

The research and development pipeline for Parkinson’s contains over 50 compounds. Unfortunately few of the products predicted to reach the market in the next in 10 years appear to offer major clinical benefits over currently marketed therapies. Neuroprotection is arguably the most exciting treatment approach to treating Parkinson’s disease according to opinion leaders interviewed by Datamonitor, Travis says. “Any drug demonstrating the ability to slow, halt or even reverse disease progression is likely to become the new gold standard and PD market leader. However despite a plethora of pipeline compounds claiming neuroprotective properties, to date, not one has come to fruition.”  

Or as one opinion leader interviewed by Datamonitor says: “Neuroprotection is a pretty big nut to crack. There have been a lot of concerns over how do you get regulatory approval for a compound that has got neuroprotection but not symptomatic benefit. So far it looks like a pretty daunting task.”

While high profile sufferers like Ali and Fox may bring more attention to the plight of Parkinson’s patients, in reality the manifestation of truly neuroprotective drugs is still at least 10 years away, Travis says. “In the meantime, early diagnosis and treatment really remain the key to treating Parkinson’s patients.”  

Notes

*Commercial Insight: Parkinson’s Disease Increased Focus on Earlier Treatment and Managing Levodopa Complications Will Drive Market Growth

**Globally is defined as the 7 major pharmaceutical markets: France , Germany , Italy , Japan , Spain , UK , and USA .