Oral Drugs May Reduce Preference for Injectable Drugs in Multiple Sclerosis Treatment

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by Patricia Silva, PhD |

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Frost & Sullivan recently published a report entitled “A Product and Pipeline Analysis of the Multiple Sclerosis Therapeutics Market” providing insight into the global multiple sclerosis (MS) drug market. In this report, a competitive evaluation of MS pharmaceutical drugs currently available in the market and experimental drugs in Phase 3 trials was performed.

MS is a chronic, progressive neurodegenerative disorder that results from an attack on the central nervous system (brain, spinal cord and optical nerves) by the body’s own immune system, causing inflammation and damage to the myelin layer that covers and protects neurons, leading to irreversible neurological disability. MS affects approximately 2.5 million people worldwide.

Progressive MS is characterized by a gradual, steady progression of disability, leading to impairment in vision and walking, pain, fatigue, incontinence and cognitive changes. Patients usually have a poor response to treatment and there is little or no recovery. Progressive MS can be either primary, where patients develop this form of the disease from the time of diagnosis, or secondary, where patients initially experience a relapsing-remitting multiple sclerosis (RRMS) phase of neurological dysfunction that later evolves into a secondary progressive disease. Primary progressive MS only affects 10 to 15% of MS patients, while the majority develops secondary progressive MS.

Injectable drugs comprise the largest portion of the MS drug market, although several new oral pipeline drugs are helping to establish oral drugs in the United States. According to the study, oral therapies are revolutionizing MS treatment as they offer enhanced dosing along with higher rates of patient compliance.

The company reports that recent therapeutic developments seek improve the tolerability of existing drugs, especially those based on interferon beta and glatiramer acetate. A focus on the development of anti-inflammatory drugs has also been observed.

Currently, the most effective treatment for MS in terms of controlling aspects of the immune system are disease modifying drugs, or ABCR treatment, where “A” stands for Avonex, “B” stands for Betaferon, “C” stands for Copaxone and “R” stands for Rebif. Avonex, Betaferon and Rebif are beta interferon drugs, while Copaxone has glatiramer acetate as an active ingredient.

“Physicians prefer Avonex, Betaferon, Copaxone, Rebif – or ABCRs – as first line therapy because of the 10 years of clinical data establishing their efficacy and safety,” said the study’s author, Frost & Sullivan Healthcare Industry Analyst Aish Vivekanandan in a news release. “As is evident, clinical data substantiating the benefits of drugs will prove to be the driving factor in enabling rapid approvals from regulatory agencies.”

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In the United States and Europe, RRMS is the most common form of MS, leading drug manufacturers to invest most of their R&D efforts in developing therapies for this form. Because of this, therapeutic drug development in MS forms such as primary progressive is urgently needed. According to the study, drug manufactures seem to now be investing in primary progressive MS disease, with several clinical studies evaluating treatment options for progressive MS and analyzing the effects of vitamin D in relapsing MS.

The study’s author also suggests that long-term clinical trials could increase the likelihood of drug approval and adoption by physicians. “Many pharmaceutical companies are gradually realizing the importance of long-term clinical studies for drugs,” said Vivekanandan. “This awareness could spur pharmaceuticals to develop low-risk drugs for the treatment of MS and build a patient base in a market with huge unmet medical needs.”

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