Frontier Pharma: Chronic, Acute and Neuropathic Pain - GPCR and Nerve Growth Factor-based therapies offer strong potential in difficult-to-treat subtypes
Summary
Pain, and in particular chronic pain, is a significant global health issue. While pain is not considered a disease in its own right, there is a growing body of evidence that substantiates chronic pain as a disease, rather than just as a symptom of a primary cause. In the US, pain affects more people than cancer, diabetes and heart disease combined, with an estimated 100 million people having experienced at least one chronic pain episode in the last 12 months, at an annual cost of around $600 billion in medical treatment and lost productivity.
The pain therapeutics market has been largely characterized by only incremental product innovation over the last decade, as most market segments continue to be dominated by long-established product categories, active pharmaceutical ingredients and concomitant mechanisms of action.
Moderate-to-severe pain has been and continues to be dominated by opioids, which are increasingly being reformulated to offer abuse-resistance, whereas mild pain is effectively treated with non-steroidal anti-inflammatory drugs (NSAID). However, significant unmet needs remain, as chronic pain subtypes - and particularly neuropathic pain - do not respond well to existing therapies, which do not align to the underlying molecular pathophysiological profile of pain.
However, strong unmet needs remain in core therapy types such as NSAIDs, which are associated with often severe gastrointestinal adverse events (AE), and opioids, which have a range of AEs associated with them - in addition to the potential for abuse, which has not been fully alleviated by the development of abuse-deterrent formulations.
The exceptionally large active pain pipeline, second only to breast cancer in terms of size, consists of 810 products across all stages of development, indicating that a great deal of resources are being invested into R&D, with the aim of ultimately overcoming the limitations of existing therapies.
Moreover, GBI Research’s analyses identified 129 first-in-class programs in active development, constituting 20% of the pipeline for which there is a disclosed molecular target, and acting on 80 distinct first-in-class molecular targets. Although there is significant differentiation in the scientific rationale and clinical prospects across these first-in-class products, the majority of first-in-class targets demonstrate significant preclinical evidence, and alignment to molecular pathophysiological changes.
Scope
Chronic pain treatment pipeline could yield innovative alternatives to opioids, says GBI Research
Although opioids continue to dominate the chronic pain market, adverse events associated with the drug such as the potential for abuse mean the treatment space is rife with unmet needs, which is encouraging pharmaceutical companies to explore innovative alternatives to opioids, according to business intelligence provider GBI Research.
The company’s latest report states that while opioids remain the most effective modes of treatment, their potential for abuse has yet to be addressed, and thus their effectiveness is limited in chronic pain conditions, as they cannot be used for prolonged durations.
Dominic Trewartha, Managing Analyst for GBI Research, states that: “Moderate-to-severe pain has been and continues to be dominated by opioids, which are increasingly being reformulated to offer abuse resistance, whereas mild pain is effectively being treated with non-steroidal anti-inflammatory drugs (NSAID).“However, significant unmet needs remain, as chronic pain subtypes - and particularly neuropathic pain - often do not respond well to existing therapies, which do not align well with the underlying molecular pathophysiological causes of pain.”
While the pain therapeutics pipeline is extremely large and diverse, it is characterized by a high overall historic clinical attrition rate for novel analgesics, and a low level of first-in-class innovation.
The active pain pipeline is populated by 810 products across all stages of development, which exhibit a highly diverse range of molecular targets. GBI Research’s analyses identified 129 first-in-class programs in active development, constituting 20% of the pipeline for which there is a disclosed molecular target, and acting on 80 first-in-class molecular targets.Trewartha explains: “Although this level of innovation is lower than the overall averages for central nervous system disorders and the industry as a whole, this segment of the pipeline nevertheless comprises a diverse range of promising products, which offer significant potential to yield clinical improvement.“While many companies are following a strategy of developing products with similar mechanisms of action to existing products, there are also many innovative products in the pain pipeline. These first-in-class products reflect a deepening scientific understanding of the underlying pathophysiology of pain, and a growing list of molecules that have been implicated in the initiation of acute pain and progression to a chronic pain state.”
Frontier Pharma: Chronic, Acute and Neuropathic Pain - GPCR and Nerve Growth Factor-based therapies offer strong potential in difficult-to-treat subtypes
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