According to Research and Markets, the only current approved neuroprotective therapy in Europe is memantine, which is awaiting approval in the US. Neuroprotection is seen as a better alternative to acetylcholinesterase inhibitors which treat the symptoms of the disease and are the most viable form of treatment currently available.
With nearly 8 million sufferers from this condition and anticipated increases in the future, considerable research is in progress to understand the pathomechanism of the disease and find a cure. While sufferers show improvements when taking acetylcholinesterase inhibitors, their mechanism of action does not correct the basic pathology of the disease, the beta amyloid deposits or neurofibrillary tangles that are characteristic of the disease.
There are non-pharmacological approaches such as vagal nerve stimulation and cerebrospinal fluid shunting, which are in clinical trials. Genotyping, particularly of ApoE gene alleles is also useful in the evaluation of cases and planning management. The value of mental exercise in delaying the onset of Alzheimer's disease is being recognized.
Early diagnosis of Alzheimer's disease is an important first step in management. Several biomarkers in cerebrospinal fluid, blood and urine can detect the disease. They provide a valuable aid to the clinical examination and neurophysical testing which are the main diagnostic methods supplemented by brain imaging.
The report cites the use of animal models as important for research into the disease, especially in testing the potential therapeutic approaches. Whilst pharmaceutical research into beneficial compounds has been relatively successful, the 120 different compounds at various stages of development will take time to filter out and develop.
The study predicts that over the next five years, acetyl cholinesterase inhibitors will continue to dominate the market, but Forest's Namenda, a recently launched NMDA receptor antagonist, will gain market share as a combination product.
With increasing patient numbers and the limitations of available therapies, the Alzheimer's disease (AD) market is an attractive investment with huge unmet need. Although it occupies a small share of the total CNS market it is currently experiencing massive growth. Alzheimer's disease market in the seven major markets is worth $4.7 billion (€3.8 billion) and will increase to $6.1 billion by the year 2005 and $ 7.8 billion by the year 2010.