Neurological Disorders are one of the most leading causes of injuries, death, and disability. Over more than 600 Neurological Disorders are believed to affect millions of people worldwide. These disorders have a deep impact on the patients, their families, and society at large. As per the systematic analysis for the “Global Burden of Disease Study 2016” by Prof Valery L Feigin, et. al., “Neurological Disorders contribute to around 11·6% of global DALYs and are the causes of 16·5% of deaths, overall second leading group cause of deaths in the world”.
Neurological Disorders affect the most delicate part of the body such as the brain and the central and autonomic nervous systems. The burden is increasing at a substantial rate and these disorders are widely unrecognized especially in low and mid-income countries. The causes of neurological symptoms can be due to various diverse factors. Age is one of the major contributors to the development of certain Neurological Disorders such as Parkinson’s disease and Alzheimer’s. While some other major risk factors for Neurological Disorders include infections, nutritional deficiencies, lifestyle-related changes, certain physical injuries, and stress. Similarly, genetics, immune response, and environmental factors also influence the occurrence of Neurological Conditions
With the advancement in technology, today diagnostics testing such as neurological examination, brain scans, genetic screening, and other tests are available to examine the occurrence of Neurological Conditions. Similarly, the treatment also plays an important role to minimize the burden of Neurological Disorder and its progression. Over the past few years, certain medications have been approved worldwide for the treatment of Neurological Disorders. Similarly, many clinical trials are going on to further strengthen the therapeutic pipeline for different Neurological Conditions.
Worldwide, millions of people are affected with Neurological Disorders, however many of the cases remain undiagnosed and untreated due to limited knowledge and available resources. Several of the disorders are rare which possess a significantly high risk due to limited study around these disorders. We have compiled a list of the common Neurological Disorders worldwide and the key companies focussing to address the respective conditions –
Stroke is the most common Neurological Condition. It affects the arteries leading to and within the brain that result in a decrease or blockage in the brain’s blood supply. Stroke can be of three types namely ischemic stroke, hemorrhagic stroke, transient ischemic attack. As per the WHO, “an estimated 15 million individuals worldwide suffer from stroke each year. Of these, 5 million dies, and another 5 million are left permanently disabled”. As per the study conducted by Edward C Jauch et. al. 2019, nearly 800,000 people suffer from strokes each year in the United States and 82–92% of these strokes are ischemic.
The main treatment option against ischemic stroke is intravenous tissue plasminogen activator (tPA), which breaks up clots. tPA is most effective when given within four and a half hours from the start of a stroke. Surgery is also employed to remove the clot. Currently, companies such as Athersys, Abbvie, Bristol-Myers Squibb, Lumosa Therapeutics, Teijin Pharma Limited, etc. are involved in developing therapies for Acute Ischemic Stroke (AIS).
Epilepsy and Seizures
Epilepsy is a central nervous system (neurological) disorder that results in recurring seizures due to which the person experiences unusual behavior, sensations, and sometimes loss of awareness. Epilepsy can affect people of all ages and the symptoms also vary from person to person. As per the WHO, “more than 50 million people have Epilepsy worldwide”. Similarly, according to the CDC, in 2015, “about 3.4 million people suffer from Epilepsy in the USA which is nearly 1.2% of the population can be further segmented as 3 million adults and 470,000 children”.
The treatment for Epilepsy includes antiepileptic medications (AEDs), diet therapy, and surgery. The medications treat the symptoms of Epilepsy (the seizures), rather than curing the underlying condition. Several therapies have been approved in the Epilepsy Market. The Epilepsy Treatment Market is dominated by antiepileptic medications (AEDs), which is the early treatment choice for almost all patients with multiple seizures. However, several global companies such as Aquestive Therapeutics, UCB Biopharma, Marinus Pharmaceuticals, Takeda, Jazz Pharmaceuticals, and Zynerba are exploring other potential treatment options for Epilepsy.
Alzheimer’s Disease and Dementia
Dementia affects the memory, thinking, and behavior of the person that hampers the ability of the person to perform everyday activities. As per the WHO, around 50 million people worldwide have dementia, and there are nearly 10 million new cases every year.
There are several types of Dementia and among all the Alzheimer’s is the most common and may contribute to 60–70% of cases. In 2020, nearly 6 million Americans were observed to be affected with Alzheimer’s and people above age 60 are found to be more affected than any other age group.
Currently, there is no cure for Alzheimer’s Disease. The available therapies focus on maintaining mental function, manage behavioral symptoms, and slow down certain problems, such as memory loss. In June 2021, Aducanumab by Biogen received FDA approval to treat patients with Alzheimer’s disease. Similarly, other companies in the domain such as Eisai/ BioArctic AB, Hoffmann-La Roche/Chugai Pharmaceuticals, Anavex Life Sciences Corp., and Neurimmune are actively working in the Alzheimer’s Therapeutics Market.
Worldwide, nearly 10 million people are expected to be living with Parkinson’s Disease. In Parkinson’s Disease, dopamine-producing (“dopaminergic”) neurons are affected which results in low dopamine levels in the brain. Parkinson’s Disease may lead to tremors, slowness of movement, stiff muscles, unsteady walk, and changes in speech. According to Parkinson’s Foundation, in the United State, around one million people are living with Parkinson’s Disease. Every year, nearly 60,000 Americans are diagnosed with PD, and by 2030 the cases are expected to rise to 1.2 million. Parkinson’s Disease has no cures and available pharmacological treatments are symptomatic. Pharmacological therapies can only limit or slow down symptoms of PD. At present, the Parkinson’s Disease Market lacks the drugs that can target the underlying cause of PD.
With the continuous efforts by the pharma companies over the years, the therapeutic landscape for Parkinson’s Disease looks promising with several therapies in Phase II and Phase III of the clinical development. The companies in the Parkinson’s Disease Therapeutics Market include Cortexyme, Cerevel Therapeutics, Amneal Pharmaceuticals, Pharma Two B, Cerevance, AbbVie, Theranexus, and others. Companies are focusing on the development of adherence-friendly drug formulations, Gene therapy, a drug for better treatment of motor symptoms.
Multiple Sclerosis is a nervous system disease affecting the brain and spinal cord that result in muscle weakness, tingling, numbness, difficulty in coordination and balance, and blurred vision. The exact cause of the disease is still unknown however certain environmental and genetic factors are expected to influence the occurrence of Multiple Sclerosis. As per the study conducted by Clare Walton et. al., a total of 2.8 million people are estimated to live with Multiple Sclerosis worldwide (35.9 per 100,000 population). Women are found to be affected twice as compared to men.
To tackle Multiple Sclerosis several disease-modifying therapies (DMT) are available in the market. However, injectables and intravenous therapies dominate the market. Over the past few years, many therapies have been approved for Multiple Sclerosis. Looking at the market potential, companies such as Biogen, Novartis, Merck, Imcyse, NervGen and are developing therapies for Multiple Sclerosis.
Migraine is a neurological condition that results in severe headaches, throbbing pain, or a pulsing sensation. The headaches are recurring and debilitating that can last for hours or days. As per the World Health Organization, Migraine is the 19th most common reason for disability. According to the Migraine Research Foundation, nearly 39 million people in the US and 1 billion people all over the globe are affected by Migraines. The worldwide prevalence of Migraines is expected to be more than 10%.
The Migraine treatment approaches follow an acute or preventive treatment option. Acute treatment is initiated during an attack to alleviate pain and disability and to stop the progression of the attack. Preventive treatment is maintained for months or even years to reduce the frequency, severity, and duration of attacks. Several medications are available in the market to treat Migraines. At present, key companies such as Axsome Therapeutics, Impel NeuroPharma, Zosano Pharma Corporation, and many others are involved in developing therapies for Migraines. Similarly, several players are exploring the possibility of medical devices to bring about an effect on the neural activity in the brain to relieve pain and prevent headaches. The key companies in the Migraine medical devices segment include Cefaly, Neurolief Ltd., Chordate Medical, Theranica Bio-Electronics Ltd., Electrocore Inc., eNeura Inc., BMedical Pty Ltd, Prolivio, Cirrus Healthcare Products, Cirrus Healthcare Products, and several others.
Apart from these some other most common Neurological Disorders include Poliomyelitis, Meningitis, Tetanus, Japanese encephalitis, and Cerebral Palsy.
What lies ahead
The burden of Neurological Disorder is rapidly increasing and leading to a substantial disability and poor quality of life for the affected person and their families. These disorders are closely associated with physical, psychological, social, and economic aspects of life. Also, there is a certain stigma associated with Neurological Disorders that make people avoid the negative social consequences of society if they undergo a diagnosis. Similarly, the limited access to medicines, diagnostics, and technology are also major challenges in Neurological Disorder treatment.
To reduce the burden, the government needs to focus more on bringing awareness, spending more on research activities, and the healthcare system. If prevention and treatment strategies are followed today, in the coming years the situation is expected to improve significantly. Similarly, companies in the Neurological Disorder market are focusing on developing therapies with better outcomes. Certain pipeline drugs in the various stages of clinical development are designed to address the long-standing unmet need. A better understanding of disease pathogenesis and the launch of the emerging novel therapeutics is expected to reduce the burden of Neurological Disorders.