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Frontier Pharma: Chronic, Acute and Neuropathic Pain - GPCR and Nerve Growth Factor-based therapies offer strong potential in difficult-to-treat subtypes

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

  • Analysis of innovation in the pain markets (including both nociceptive and neuropathic pain, of both a chronic and acute nature), in the context of the overall pipeline and current market landscape. Also includes analysis of the deals landscape surrounding first-in-class products in pain, and highlights opportunities for in-licensing.
  • A brief introduction to chronic and acute pain, including subtypes, symptoms, pathophysiology, and an overview of pharmacotherapy and treatment algorithms.
  • The changing molecular target landscape between the market and the pipeline, and particular focal points of innovation in the pipeline.
  • Comprehensive review of the pipeline for first-in-class therapies, analyzed on the basis of stage of development, molecule type and molecular target.
  • Identification and assessment of first-in-class molecular targets, with a particular focus on early-stage programs for which clinical utility has yet to be evaluated, as well as literature reviews on novel molecular targets.
  • Assessment of the licensing and co-development deal landscape for pain therapeutics, and benchmarking of deals involving first-in-class versus non-first-in-class-products.
Reasons to buy
  • Understand the current clinical and commercial landscape, including a comprehensive study of disease pathogenesis, diagnosis, prognosis and the available treatment options available at each stage of diagnosis.
  • Visualize the composition of the pain markets in terms of dominant molecule types and targets, highlighting what the current unmet needs are and how they can be addressed. This knowledge allows a competitive understanding of the gaps in the current market.
  • Analyze the pain pipeline, stratified by pain subtype, stage of development, molecule type and molecular target.
  • Assess the therapeutic potential of first-in-class targets. Using a proprietary matrix, first-in-class products have been assessed and ranked according to clinical potential. Promising early-stage targets have been further reviewed in greater detail.
  • Identify commercial opportunities in the pain deals landscape by analyzing trends in licensing and co-development deals, and producing a list of pain therapeutics that are not yet involved in deals and may be potential investment opportunities.


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

  • Comments provided by Dominic Trewartha, Managing Analyst for GBI Research.
  • Information based on GBI Research’s report: Frontier Pharma: Chronic, Acute and Neuropathic Pain.
  • This report was built using data and information sourced from proprietary databases, primary and secondary research, and in-house analysis conducted by GBI Research’s team of industry experts.

1.1 List of Tables
Table 1: Pain Market, Global, Categories of Pain, 2016 10
Table 2: Pain Market, Global, Data for Nerve Growth Factor as a Molecular Target, 2016 36
Table 3: Pain Market, Global, Data for High Affinity Nerve Growth Factor Receptor as a Molecular Target, 2016 36
Table 4: Pain Market, Global, Data for Tumor Necrosis Factor Receptor Superfamily Member 16 as a Molecular Target, 2016 38
Table 5: Pain Market, Global, Data for Bradykinin B1 Receptor as a Molecular Target, 2016 40
Table 6: Pain Market, Global, Data for Opioid Receptor-Like-1 Receptor as a Molecular Target, 2016 42
Table 7: Pain Market, Global, Data for Purinoceptor 7 as a Molecular Target, 2016 44
Table 8: Pain Market, Global, Data for Metabotropic Glutamate Receptor 6 as a Molecular Target, 2016 45
Table 9: Pain Market, Global, Data for Metabotropic Glutamate Receptor 7 as a Molecular Target, 2016 45
Table 10: Pain Market, Global, Data for Calcitonin Gene-Related Peptide Type-1 Receptor as a Molecular Target, 2016

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