Parkinsons Disease Therapeutics in Major Developed Markets to 2021: Early Pipeline Shifts Towards Disease-Modifying Therapies, while Short Term Growth Driven by Long-Acting Symptomatic Treatments

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Parkinson's Disease (PD) is a progressive, chronic neurodegenerative condition, which is currently incurable. It is associated with old age, and characterized by the loss of neurons in the substantia nigra region of the brain. The global Parkinson's Disease (PD) prevalence was estimated at 16.1 million in 2011, and after Alzheimer's disease it is the second most common neurodegenerative disease worldwide.

Parkinson's Disease (PD) is a progressive disease and, although not fatal, it can develop severe symptoms and complications that significantly impact upon the patient's quality of life. Symptoms for each stage can be categorized into early, moderate and advanced stages. Major motor symptoms of Parkinson's Disease (PD) include tremors and difficulty walking. Parkinson's Disease (PD) also gives rise to non-motor symptoms, such as dementia, depression, hallucinations and loss of taste and smell.

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There are several different drug classes available to relieve Parkinson's Disease (PD) symptoms. The aim is for treatments to increase dopamine levels, which is substantially diminished in brains affected by Parkinson's Disease (PD). The most common therapies include levodopa, dopamine agonists and Monoamine Oxidase-B (MAO-B) inhibitors, with the choice of therapies dependent on patient symptoms and lifestyle. As the disease develops, the medication will need to be taken more strictly, due to the effect of drugs wearing off (known as offtime), which causes symptoms to return before the next dose.

With the current marketed drugs focusing primarily on symptomatic relief, Parkinson's Disease (PD) remains incurable, with a huge unmet need for disease-modifying therapies. However, due to the lack of clearly established clinical trial methodologies, replication of the benefits demonstrated by neuroprotective agents in the laboratory to human trials has proved challenging. More importantly, due to an incomplete understanding of the underlying mechanisms that cause the disease, a viable therapeutic target to halt or slow disease progression is currently not in scope, which limits the effectiveness of current product development programs.

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Table of Contents

1 Table of Contents
1 Table of Contents 5
1.1 List of Tables 7
1.2 List of Figures 7

2 Introduction 9
2.1 Disease Introduction 9
2.2 Symptoms 9
2.3 Etiology 10
2.3.1 Genetic Factors 10
2.3.2 Environmental Factors 11
2.3.3 Aging 11
2.4 Pathophysiology 12
2.5 Epidemiology 13
2.6 Disease Stages 14
2.7 Co-morbidities and Complications 15
2.8 Diagnosis 15
2.9 Assessment of Disease Severity 16
2.9.1 Hoehn and Yahr scale 16
2.9.2 Unified Parkinson’s Disease Rating Scale 16
2.10 Treatment 17
2.10.1 Pharmacological Therapies 18
2.10.2 Non-pharmacological Treatments 20
2.11 Treatment Algorithm 21
2.11.1 Early Parkinson’s Disease 21
2.11.2 Advanced Parkinson’s Disease 22

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