Report: European Neuropathic Pain TOC

I. EXECUTIVE SUMMARY

II. INTRODUCTION AND METHODOLOGY

III. PHYSIOLOGY OF PAIN

A. Definition of Neuropathic Pain Conditions

1. Nerve Injury
2. Long Duration
3. Abnormal Sensations
4. Aggravation by Physiological Processes
5. Cellular Mechanisms of Neuropathic Pain: 5.1 Peripheral Mechanisms of Neuropathic Pain; 5.2 Spinal Cord Mechanisms of Neuropathic Pain; 5.3 Mechanisms of Central Neuropathic Pain

B. Definition of Neuropathic Pain States

1. Neuropathic Low-Back Pain
2. Diabetic Neuropathy
3. Post-Herpetic Neuralgia
3. Trigeminal Neuralgia (tic douloureux)
4. HIV/AIDS Neuropathy

IV. MEASUREMENT OF PAINFUL CONDITIONS

A. Pain Measurement Scales

1. Qualitative Assessments
2. Standard Quantitative Pain Measurement Scales: 2.1 Visual Analog Scale; 2.2 McGill Pain Questionnaire; 2.3 The Neuropathic Pain Scale

B. Clinical Assessment of Neuropathic Pain

V. EPIDEMIOLOGY - CURRENT AND FUTURE

A. Neuropathic Back Pain

1. Low-Back Pain
2. Low-Back Pain Incidence and Prevalence
3. Chronic Low-Back Pain Prevalence
4. Neuropathic, Chronic Low-Back Pain Prevalence
5. Basis for Target Population
6. Five-Country Neuropathic, Chronic Low-Back Pain Population Projections

B. Diabetic Neuropathy

1. Diabetic Neuropathy
2. Diabetes Prevalence
3. Diabetic Neuropathy Prevalence
4. Symptomatic Diabetic Neuropathy Prevalence
5. Severe Diabetic Neuropathic Pain Prevalence
6. Basis for Target Population Projections
7. Five-Country Diabetic Neuropathy Population Projections

C. Post-Herpetic Neuralgia

1. Post-Herpetic Neuralgia
2. Herpes Zoster Incidence
3. Post-Herpetic Neuralgia Incidence
4. Post-Herpetic Neuralgia Prevalence
5. Basis for Target Population Projections
6. Five-Country Post-Herpetic Neuralgia Population Projections

D. Trigeminal Neuralgia

1. Trigeminal Neuralgia
2. Trigeminal Neuralgia Incidence and Prevalence
3. Basis for Target Population
4. Five-Country Trigeminal Neuralgia Population Projections

E. HIV/AIDS Neuropathic Pain

1. HIV/AIDS Pain
2. HIV/AIDS Incidence and Prevalence
3. AIDS Incidence and Prevalence
4. HIV/AIDS Pain Prevalence
5. HIV/AIDS Neuropathic Pain Prevalence
6. Basis for Target Population Projections
7. Five-Country HIV/AIDS Neuropathy Population Projections

F. References

VI. APPROACHES FOR TREATMENT OF NEUROPATHIC PAIN

A. Actual Clinical Practice

1. Antidepressants
2. Anticonvulsants
3. Local Anesthetics, Regional Nerve Blocks, and Sympathetic Nerve Blocks
4. Antiarrhythmics
5. Non-Narcotic Synthetic Opioids
6. Opioids and Semi-Synthetic Narcotics
7. Muscle Relaxants
8. NMDA Receptor Antagonists
9. VR-1 Receptor Agonists
10. Non-Steroidal Anti-Inflammatory Agents (NSAIDS)
11. Non-Pharmacologic Treatments: 11.1 Electrical Nerve Stimulation; 11.2 Acupuncture; 11.3 Hypnosis and Psychological Approaches; 11.4 Surgery

B. Clinical Practice Guidelines

C. Limitations of Current Treatment

D. Promising New Approaches

E. Future Trends

F. Drugs in Clinical Development to Treat Neuropathic Pain

1. Recent Launches
2. Current Pipeline: 2.1 Phase III, Pre-registration, and Registration; 2.2 Ion Channel Antagonists; 2.2 Glutamate Receptor Antagonists; 2.3 Cyclo-Oxygenase Inhibitors; 2.4 Cannabinoid Receptor Agonists; 2.5 Neuromuscular Blocking Agents; 2.6 Norepinephrine and Serotonin Reuptake Inhibitors; 2.7 Alpha Adrenoceptor Agonist
3. Phase II: 3.1 Glutamate/NMDA Receptor Antagonists; 3.2 Ion Channel Antagonists; 3.3 Opioid Receptor Agonists; 3.4 GABA Receptor Agonists; 3.5 Cyclo-Oxygenase 2, 5-Lipoxygenase and Platelet Activating Factor Inhibitors; 3.6 Cholecystokinin Antagonists; 3.7 Free Radical Scavengers and Mitogen-Activated Protein Kinase Inhibitors; 3.8 Nicotinic Acetylcholine Receptor Agonists; 3.9 Adenosine A1 Receptor Agonists; 3.10 Nociceptin Antagonists and Vanilloid Receptor Agonists; 3.11 Alpha 2 Adrenoceptor Agonists; 3.12 Undefined Mechanisms
4. Phase I: 4.1 GABA Receptor Agonist; 4.2 NMDA Antagonist and Monoamine Oxidase Inhibitors; 4.3 Neurotransmitter Agonists; 4.4 Ion Channel Modulators; 4.5 Superoxide Dismutase Stimulants; 4.6 Cannabinoid CB1 Receptor Agonists; 4.7 Undefined Mechanisms; 4.8 Antioxidants; 4.9 Discontinued, Suspended, or No Development Reported Drugs

E. References

VII. MARKET VALUE, CURRENT AND FUTURE

A. Current Sales of Pharmaceutical Products, by Drug Class and Condition

1. Five-Country Market Analysis:: 1.1 Anticonvulsants; 1.2 Antidepressants; 1.3 Opioids; 1.4 Other
2. European Market Summary: 2.1 Clinician Views; 2.2 Sales by Condition, Class & Country
3. Five-Country Market Analysis: Details by Class: 3.1 Neuropathic Back Pain; 3.2 Trigeminal Neuralgia; 3.3 Diabetic Neuropathic Pain; 3.4 Post-Herpetic Neuralgia; 3.5 HIV/AIDS Neuropathic Pain
4. Methodology

B. Market Forecasts for Neuropathic Pain

1. Five-Country Market Forecast ? 2007 & 2012: 1.1 Anticonvulsants; 1.2 Antidepressants; 1.3 Opioids; 1.4 Other
2. European Total Market Forecasts for Pipeline Products for the Treatment of Neuropathic Pain

VIII. APPENDICES

Partial List of Tables & Figures@

European Prevalence of Neuropathic Pain by Type, 2002 - 2012
European Neuropathic Pain Patient Prevalence Projections 2002 - 2012
Summary by Phase of Drugs in Clinical Development for Neuropathic Pain, 1999 ?2003
Drugs in Phase III, Preregistration, or Registration for Neuropathic Pain
Summary by Drug Class - 2002 European Market Value for the Treatment of Neuropathic Pain
Summary by Condition - 2002 European Market Value for the Treatment of Neuropathic Pain
European Total Market Forecasts, by Drug Class for the Treatment of Neuropathic Pain
European Projected Total Market Forecast for New Products for the Treatment of Neuropathic Pain
Appendix VIII-1: European Total Market Forecast, by Drug Class, for the Treatment of Neuropathic Back Pain.
Appendix VIII-2: European Total Market Forecast, by Drug Class, for the Treatment of Trigeminal Neuralgia.
Appendix VIII-3: European Total Market Forecast, by Drug Class, for the Treatment of Diabetic Neuropathic Pain.
Appendix VIII-4: European Total Market Forecast, by Drug Class, for the Treatment of Post Herpetic Neuralgia.
Appendix VIII-5: European Total Market Forecast, by Drug Class, for the Treatment of HIV/AIDS Neuropathic Pain

European Neuropathic Pain

Table of Contents