Peripheral Neuropathy and Neuropathic Pain, 2008

Table of Contents

1. Background

This introductory chapter gives a general overview of peripheral neuropathy (PN) and neuropathic pain (NP) including classification, causes, treatments and unmet need.

• 1.1 Peripheral Neuropathy
  • 1.1.1 Classification
  • 1.1.2 Causes
  • 1.1.3 Treatments
  • 1.1.4 Unmet Need
  • 1.1.5 Discussion
• 1.2 Neuropathic Pain
  • 1.2.1 Classification
  • 1.2.2 Causes
  • 1.2.3 Treatments
  • 1.2.4 Unmet Need
  • 1.2.5 Discussion

2. Prevalence and Trends

PN and NP are causally linked to a number of conditions, several of which are major global diseases such as diabetes, cancer and HIV infection. Chapter 2 gives an overview of the prevalences of PN and NP covering the major disease associations including diabetes, autoimmune disease, viral infections, gastrointestinal conditions, cancer, drug and toxin, autonomic nervous system, nerve compression and hereditary related. The prevalences of PN and NP are assessed for each of these, to allow global levels to be calculated.

• 2.1 Causal Links
  • 2.1.1 Diabetes
  • 2.1.2 Autoimmune
  • 2.1.3 Infection
  • 2.1.3.1 HIV
    • 2.1.3.2 Herpes Zoster
  • 2.1.4 Gastrointestinal
  • 2.1.5 Drugs and Toxins
  • 2.1.6 Cancer
  • 2.1.7 Autonomic
  • 2.1.8 Heredity
  • 2.1.9 Compression
• 2.2 Neuropathic Pain
• 2.3 Trends

3. Therapeutic Pipeline

This chapter gives a detailed presentation of the drug development pipeline, covering approximately 80 drugs being developed to treat PN and NP as primary indications and around 60 candidates, which are second-indication treatments.

• 3.1 Primary Indication Drugs
  • 3.1.1 Launched/Pre-Registration
  • 3.1.2 Phase III
  • 3.1.3 Phase II
  • 3.1.4 Phase I
  • 3.1.5 Pre-clinical
• 3.2 Secondary Indication Drugs
  • 3.2.1 Launched/Pre-Registration
  • 3.2.2 Phase III
  • 3.2.3 Phase II
  • 3.2.4 Phase I
  • 3.2.5 Pre-clinical
• 3.3. Discussion

4. Emerging Technology

This chapter presents and summarises over 300 patent filings relevant to the therapeutic targeting of PN and NP. These were published between Jan 2002 and Jan 2008. This review was been carried out to identify emerging therapeutic opportunities, which have not yet entered the drug development pipeline.

• 4.1 Patents
• 4.2 Drug Targets
• 4.3 Peripheral Neuropathy
• 4.4 Neuropathic Pain
• 4.5 Discussion
• 4.6 Companies/Assignees

5. Markets

An overview of markets relating to PN and NP including products, sales, market size, trends and companies.

• 5.1 Products
• 5.2 Sales
• 5.3 Market Size
• 5.4 Trends
• 5.5 Companies

6. Discussion

Chapter 6 gives a comprehensive overview and discussion on the findings of this report.

• 6.1 Overview
• 6.2 Prevalence and Trends
• 6.3 Unmet Need
  • 6.3.1 Peripheral Neuropathy
  • 3.3.2 Neuropathic Pain
  • 6.3.2 Targeting the Diseases
  • 6.3.4 Reversing the Disease
• 6.4 Drug Targets
• 6.5 Current Treatments
  • 6.5.1 Peripheral Neuropathy
  • 6.5.2 Neuropathic Pain
  • 6.6 Drug Pipeline
  • 6.6.1 Peripheral Neuropathy
  • 6.6.2 Neuropathic Pain
• 6.7 Markets
• 6.8 Conclusions

List of Tables

• Table 1. Drugs and chemical toxins known to cause peripheral neuropathy
• Table 2. Global prevalence of peripheral neuropathy
• Table 3. Drugs and developmental candidates (pre-clinical to launch) for the treatment of PN and NP, as primary indications
• Figure 4. Drugs and developmental candidates (pre-clinical to launch) for the treatment of PN and NP, as secondary indications
• Table 5. Drugs for the treatment of peripheral neuropathy and neuropathic pain
• Table 6. Sales of drugs for the treatment of peripheral neuropathy and neuropathic pain
• Table 7. Candidate drug molecules and potential drug targets which are not identified in the drug development pipeline
• Table 8. Drug targets of candidates in the pipeline, by development phase (primary indications)
• Table 9. Drug targets of candidates in the pipeline, by development phase (secondary indications)
• Table 10. Drug targets of candidates in the pipeline, by development phase (primary and secondary indications)

List of Figures

• Figure 1. Diabetes: The highest national levels (top 5 countries)
• Figure 2. Diabetes: The highest national prevalence (top five countries)
• Figure 3. Candidates at each development stage in the drug pipeline for the treatment of PN and NP, as primary indications
• Figure 4. Primary indication candidates in the drug pipeline for the treatment of PN and NP, by therapeutic group
• Figure 5. Secondary indication candidates in the drug pipeline for the treatment of PN and NP, by therapeutic group
• Figure 6. Secondary indication candidates in the drug pipeline for the treatment of PN and NP, by primary indication therapeutic group
• Figure 7. Candidates at each development stage in the drug pipeline for the treatment of PN and NP, as secondary indications
• Figure 8. Market sectors: PN and NP
• Figure 9. Number needed to treat (NNT) for different types of neuropathic pain: tricyclic antidepressants (Treat A), serotonin noradrenaline reuptake inhibitors (Treat B), gabapentin/pregabalin (Treat C), opioids (Treat D), tramadol (Treat E), NMDA antagonists (Treat F), topical lidocaine (Treat G), cannabinoids (Treat H) and capsaicin (Treat I).

Appendices

• Appendix 1. Patents relating to drug candidates and potential drug targets for the treatment of PN and NP, published from Jan 2002 to Jan 2008