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Disease-modifying drugs for Parkinson's predicted within 10 years

Tuesday January 15, 2013

Frank Irving

Physbiztech.com - The value of the global market for drugs to treat Parkinson's disease (PD) will reach $3.4 billion in 2016, according to a report released Jan. 7 by London-based business information provider visiongain.

The study, Parkinson's Disease: World Drug Market 2013-2023, finds that new first-in-class drugs will boost the market for PD pharmaceuticals. Adenosine receptor antagonists will gain approval in the near term followed by new glutamatergic drugs, with Novartis’s AFQ056 (mavoglurant) and Addex’s dipraglurant vying to be the first in this class. These approvals will invigorate the market and offset patent expiries for older drugs such as Boehringer Ingelheim’s Mirapex, according to the report.

James Evans, a pharmaceutical industry analyst with visiongain, said in a release accompanying the report: “Our analyses identify several new symptomatic treatments for unmet needs in Parkinson’s disease, including orthostatic hypotension, Parkinson’s-related psychosis and sialorrhoea. However, the R&D pipeline contains more-significant candidates than these, in the form of possible disease-modifying agents that could change the treatment paradigm. These include repurposed existing drugs such as exenatide and isradapine, and new small-molecule agents such as Phytopharm’s Cogane and Newron’s safinamide. Many possible neuroprotectants are novel agents, including gene therapies, stem cell treatments and peptides."

Evans continued, “The PD market is entering a transition away from the established drugs, toward new mechanisms of action. Requip, Mirapex and Stalevo are all off-patent now. Teva’s Azilect will become the leading drug, almost by default, as the last of the current market leaders to have some patent protection remaining."

Evans added that new and emerging therapies hold the promise of major changes to the current treatment paradigm. For example, the glutamatergic drugs may deal with levodopa-induced dyskinesia. "That might sound like a minor tweak to the existing symptomatic treatments, but actually it’s important because it would allow physicians to prescribe L-dopa earlier and more vigorously. At the moment they often hold off with L-dopa because of side effects," Evans explained. "Start using L-dopa earlier and you could dispense with agents like dopamine agonists as first-line treatments: L-dopa with the right adjuncts would be better. You also have reformulations of L-dopa in the R&D pipeline, such as Impax’s Rytary candidate, which would help drive that change."

Evans said the real goal is to get disease-modifying treatments approved, and that will begin to happen in the next 10 years. "The negative verdict on Teva’s ADAGIO trials of Azilect shows that there’s going to be a high burden of proof. But within the next five years or so there’ll be gene therapies in Phase III, products like Oxford BioMedica’s ProSavin will be on the way." He continued, "Someone is going to crack PD disease-modification in the next 10 years, and it will be a different market once that’s happened.”

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