Older Americans
November 20, 2008
More than 2,000 medicines for older Americans are currently being tested in clinical trials or are waiting for Food and Drug Administration approval, according to a new report released by the Pharmaceutical Research and Manufacturers of America (PhRMA). (Click here to see full report.)
This latest PhRMA report on new, cutting-edge medicines in the research pipeline comes as a growing number of older Americans face severe health challenges and greater life expectancy.
The National Center for Health Statistics has predicted that people born in 2005 will live for nearly 78 years. In 1955, the average American was expected to live for only 69.6 years.
Topping the health challenges for seniors are heart disease, cancer and cerebrovascular disease, according to the Centers for Disease Control and Prevention. Hypertension alone affects 67 percent of those aged 60 and older. Chronic lower respiratory diseases, Alzheimer’s disease, diabetes, and flu and pneumonia complete the seven chronic diseases that are the leading causes of death in older Americans.
The new medicines include 235 for diabetes, which affects 10.9 million Americans age 65 and older; 62 for eye disorders that contribute significantly to late-life disability; and 91 for Alzheimer’s disease, which could afflict 16 million people by 2050 without further advances in treatment. Other medicines target depression, osteoporosis, Parkinson’s disease, prostate disease, bladder and kidney diseases, and other debilitating conditions.
Among the experimental treatments is a medicine that could potentially prevent or reverse the progression of Alzheimer’s disease.
Alzheimer’s Disease: More than 5 million Americans are living with Alzheimer’s disease, with 98 percent of those over age 65, according to the Alzheimer’s Association. A potential medicine in development is a humanized monoclonal antibody designed to remove beta amyloid protein from the brain and prevent or reverse progression of Alzheimer’s disease. The medicine provides the patient with antibodies directly, rather than the patient having to create their own immune response to beta amyloid. This process – called passive immunization – may provide greater reduction or the elimination of safety concerns due to the lack of stimulation to the patient’s immune response to beta amyloid.
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Depression – In its many forms, depression affects more than 6.5 million Americans age 65 or older, according to the National Alliance on Mental Illness. One medicine in development is an inhibitor of a brain enzyme that is responsible for decreases of neurotransmitter levels that can cause depression. Depression is associated with decreased levels of three neurotransmitters – serotonin, norepinephrine and dopamine. These transmitters are needed to maintain normal mood, and when decreased, patients can become depressed. Currently available medicines that act against the brain enzyme – and help to maintain healthy levels of the three neurotransmitters – require dietary restrictions to avoid cardiovascular side effects. The potential new medicine is highly selective and allows normal metabolization of food and a diet free of restrictions.
Diabetes: Among Americans age 65 and older, 10.9 million have diabetes, according to the American Diabetes Association. Uncontrolled diabetes can lead to kidney failure, blindness, amputations and premature death. A new, first-in-class medicine in development addresses insulin resistance, the underlying cause of type 2 diabetes. The medicine selectively modulates genes responsible for insulin sensitization without activating genes responsible for weight gain and edema.
Epilepsy: A seizure disorder affecting more than 3 million Americans of all ages, with the highest incidence in children under the age of 2 and adults over age 65, according to the Epilepsy Foundation. A potential first-in-class medicine in development may treat epilepsy facilitating specific neuronal potassium channels.
Insomnia: The prevalence of insomnia is higher among older adults. According to the National Sleep Foundation’s 2003 Sleep in America poll, 44 percent of older persons experience one or more of the nighttime symptoms of insomnia at least a few nights per week or more. One potential medicine binds more selectively than currently marketed products at the specific subtype of GABA-A receptors within the brain believed to be responsible for promoting sleep.
Macular Degeneration: Age-related macular degeneration (AMD) currently affects 1.8 million Americans, but due to the rapidly aging U.S. population, that number is expected to rise to almost 3 million by 2020, according to the National Eye Institute. The potential first-in-class medicine targets vascular endothelial growth factor receptor-1 (VEGFR-1). VEGFR-1 is a key component of the VEGF pathway and is stimulated by both VEGF and PIGF (placental growth factor) resulting in the growth of new blood vessels (angiogenesis). The medicine is designed to reduce angiogenesis mediated by both VEGF and PIGF, a cause of age-related macular degeneration.
Parkinson’s Disease: Approximately one million Americans suffer from Parkinson’s disease, and each year 60,000 new cases are diagnosed – one every nine minutes, according to the National Parkinson Foundation. Currently available treatments for Parkinson’s disease can diminish the symptoms of the disease, but do not replace lost nerve cells or halt the progression of the disease. A nervous system growth factor (gene therapy) is being studied. The therapy aims to deliver the growth factor, glial derived neurotrophic factor (GDNF), into the brain to prevent degeneration and the loss of the neurotransmitter dopamine.
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