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Pipeline Insight: Mild Cognitive Impairment - Unlocking the potential of prodromal Alzheimer's disease and beyond

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IntroductionMCI is a borderline condition between normal aging and dementia affecting around 23.4 million subjects across the seven major markets (US, Japan, France, Germany, Italy, Spain and the UK) …

IntroductionMCI is a borderline condition between normal aging and dementia affecting around 23.4 million subjects across the seven major markets (US, Japan, France, Germany, Italy, Spain and the UK) in 2007, 37% of whom were suffering from prodromal Alzheimer's disease. MCI-specific annual sales are expected to increase seven-fold from 2007 to $3.3 billion across the seven major markets by 2018.Scope*Definition and prevalence of MCI and its major sub-types.*Review of the key unmet needs in the treatment of the MCI subtypes as identified by key opinion leaders.*MCI-specific drug sales value and number of treated patients forecasts to 2018 in the US, Japan, and five major European markets.*Pipeline analysis with detailed profiles for key late-stage drugs potentially appropriate for MCI patients.HighlightsDriven by off-label sales of several products currently in development for Alzheimer's disease, MCI-specific annual sales are expected to increase seven-fold from 2007 to $3.3 billion across the seven major markets by 2018.Although Datamonitor anticipates growth in the number of treated MCI patients (2.3% in 2007 rising to 4.27% in 2018), the treatment rate will remain hampered by the slow uptake of relatively expensive diagnostic tools and lack of marketing authorization for drugs within the forecast period.In the long-term, Datamonitor believes that MCI will become a viable indication expansion opportunity for companies marketing dementia drugs. However, the current marketed drugs for Alzheimer's disease are not appropriate, and new drugs for dementia are still a few years from the market.Reasons to Purchase*Better understand the concept of MCI and its limits in the identification of the syndromes sub-types and the approval of treatments.*Quantify the MCI-specific market to 2018 in the US, Japan, and five major European markets and identify the drivers and resistors in this market.*Understand unmet needs and opportunities in the definition, diagnosis and management of MCI based on key opinion leader comments.

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  • 1. Find Industry reports, Company profilesReportLinker and Market Statistics >> Get this Report Now by email!Pipeline Insight: Mild Cognitive Impairment - Unlocking the potentialof prodromal Alzheimers disease and beyondPublished on April 2009 Report SummaryIntroductionMCI is a borderline condition between normal aging and dementia affecting around 23.4 million subjects across the seven majormarkets (US, Japan, France, Germany, Italy, Spain and the UK) in 2007, 37% of whom were suffering from prodromal Alzheimersdisease. MCI-specific annual sales are expected to increase seven-fold from 2007 to $3.3 billion across the seven major markets by2018.Scope*Definition and prevalence of MCI and its major sub-types.*Review of the key unmet needs in the treatment of the MCI subtypes as identified by key opinion leaders.*MCI-specific drug sales value and number of treated patients forecasts to 2018 in the US, Japan, and five major European markets.*Pipeline analysis with detailed profiles for key late-stage drugs potentially appropriate for MCI patients.HighlightsDriven by off-label sales of several products currently in development for Alzheimers disease, MCI-specific annual sales are expectedto increase seven-fold from 2007 to $3.3 billion across the seven major markets by 2018.Although Datamonitor anticipates growth in the number of treated MCI patients (2.3% in 2007 rising to 4.27% in 2018), the treatmentrate will remain hampered by the slow uptake of relatively expensive diagnostic tools and lack of marketing authorization for drugswithin the forecast period.In the long-term, Datamonitor believes that MCI will become a viable indication expansion opportunity for companies marketingPipeline Insight: Mild Cognitive Impairment - Unlocking the potential of prodromal Alzheimers disease and beyond Page 1/12
  • 2. Find Industry reports, Company profilesReportLinker and Market Statisticsdementia drugs. However, the current marketed drugs for Alzheimers disease are not appropriate, and new drugs for dementia arestill a few years from the market.Reasons to Purchase*Better understand the concept of MCI and its limits in the identification of the syndromes sub-types and the approval of treatments.*Quantify the MCI-specific market to 2018 in the US, Japan, and five major European markets and identify the drivers and resistors inthis market.*Understand unmet needs and opportunities in the definition, diagnosis and management of MCI based on key opinion leadercomments. Table of ContentABOUT HEALTHCARE 2About the Central Nervous System pharmaceutical analysis team 2CHAPTER 1 EXECUTIVE SUMMARY 3Scope of the analysis 3Datamonitor insight into the mild cognitive impairment market 5Key metrics 7Datamonitor Pipeline Assessment Summary 9Contributing experts 10Related reports 10Upcoming reports 10CHAPTER 2 PIPELINE OVERVIEW AND DYNAMICS 12Pipeline overview 14Lack of pipeline drugs targeting mild cognitive impairment 14Mild cognitive impairment pipeline dominated by potentially disease-slowing therapies 15Key companies involved in the mild cognitive impairment pipeline 18Allon Therapeutics 18The only company targeting amnestic mild cognitive impairment as a primary indication 18AL-108 showed mixed Phase II results in amnestic MCI patients 19The heterogeneity of the amnestic mild cognitive impairment population may induce misleading Phase II results 19Trials in mild cognitive impairment patients should not be conducted before the development of diagnostic tools specific to eachdisease subtype 20Pfizer/Medivation/Wyeth 20Presence in the current market with Aricept 20License agreements and mergers develop potential MCI portfolio 20Key R&D company strategies 21Mild cognitive impairment - a future indication expansion opportunity 21Working on the development of better diagnostic tools 22Wyeth has already partnered with diagnostic company Adlyfe to develop better tools 22TauRx Therapeutics is developing its own biomarkers 22CHAPTER 3 PATIENT POTENTIAL 23Definition of mild cognitive impairment 24Mild cognitive impairment - a borderline condition between normal aging and dementia 24Pipeline Insight: Mild Cognitive Impairment - Unlocking the potential of prodromal Alzheimers disease and beyond Page 2/12
  • 3. Find Industry reports, Company profilesReportLinker and Market StatisticsEvolution of mild cognitive impairment definition 24Mild cognitive impairment diagnostic criteria 24Clinical segmentation of mild cognitive impairment 26Working areas and their significance for pharmaceutical companies 27The broad definition of mild cognitive impairment is problematic for the development and approval of new drugs 27Mild cognitive impairment - an early status of several dementia 29Ongoing discussion on the inclusion of mild cognitive impairment in DSM-V 30Uncertainty for the inclusion of psychiatric and somatic cognitive impairments in mild cognitive impairment 30Cognitive disorders - mild cognitive impairment and beyond 31Other definitions of cognitive impairments - both broader and narrower than mild cognitive impairment 31Cognitive impairments in international diseases classifications 31Epidemiology of mild cognitive impairment 32Prevalence of mild cognitive impairment 32Mild cognitive impairment affects up to 20% of the seven major markets population aged 65 years and over 32Mild cognitive impairment prevalence increases with age 35Prevalence and progression of mild cognitive impairment subtypes 35Mild cognitive impairment patients are at increased risk for dementia 35Alzheimers disease is the most frequent outcome of mild cognitive impairment 36Link between amnestic mild cognitive impairment and early dementias 36Imprecise relationship between symptoms and outcomes 37Relationship between amnestic-mild cognitive impairment and prodromal Alzheimers 38Different types of dementia 40Treatable population 41Number of treated MCI patients estimated at around 548,300 in 2007 41Presentation and diagnostic combined rate lower than 10% in MCI 42Mild cognitive impairment treatable population in 2007 43Segmentation of the mild cognitive impairment population in 2007 44Etiology of mild cognitive impairment 46Etiology of mild cognitive impairment can be linked to underlying neurodegenerative disorder 46Causes of mild cognitive impairment - Alzheimers disease etiology 46Causes of mild cognitive impairment - frontotemporal dementia etiology 48Diagnosis of mild cognitive impairment 49Lack of consensus in diagnostic tools 49Heterogeneity of mild cognitive impairment measures and rating scales 49Variability on normal reference standards across studies 49Accurate diagnosis may demand a combination of exams 51Diagnostic tools 51Neuroimaging tests - a beneficial tool for mild cognitive impairment future diagnosis 52Proposed criteria for effective biomarkers in mild cognitive impairment 55Example of other biomarkers potentially suitable to MCI 56Urine and serum biomarkers 56Neurological tests and questionnaires 57Unmet needs in mild cognitive impairment 61Unmet need overview 61Consensus on the definition and categorization of mild cognitive impairment 62Improving the definition of each subtype of the mild cognitive impairment population in correlation with a specific outcome 62Development of diagnostic tools 63Need to develop diagnostic tools able to identify specific subtypes of patients 63Consensus on diagnosis criteria 64Specific and sensitive biomarkers could help to diagnose mild cognitive impairment patients likely to progress to Alzheimers diseasePipeline Insight: Mild Cognitive Impairment - Unlocking the potential of prodromal Alzheimers disease and beyond Page 3/12
  • 4. Find Industry reports, Company profilesReportLinker and Market Statisticsor other dementia 65Need for more sensitive neurological tests 65Development of therapeutic solution 66Delay of progression to dementia with the approval of disease-slowing drugs 66Approval of effective symptomatic drugs will slightly improve MCI patients quality of life 67CHAPTER 4 MARKET OVERVIEW AND POTENTIAL 68Current market size 70Market value methodology 70Mild cognitive impairment-specific sales estimate methodology 70ATC class choice 70Medical data for indication-specific sales 71Age range choice 71Mild cognitive impairment-specific sales calculations 74MCI market value estimates 74MCI-specific market value estimated at $440m in 2007 74Mild cognitive impairment sales revenue led by anti-Alzheimers products 75Disparities in mild cognitive impairment market across regions 76Forecast methodology 77Overview of Datamonitors forecast methodology 77Evolution in patient numbers over the forecast period 79Mild cognitive impairment presentation and diagnosis combined rate forecast to increase from around 8% in 2007 to 20.1% in 201880Market forecast overview 83Total market forecasts 83MCI-specific sales revenue expected to increase by seven-fold to 2018 84Key late-stage pipeline drug forecasts 85CHAPTER 5 R&D APPROACH 88Classification of pipeline products 89Lack of pipeline drugs targeting MCI as a primary indication 89Patient potential 89Patient potential of pipeline drugs depends on their mechanism of action 89Symptomatic treatments 90Symptomatic drugs possess a large patient potential 90Disease-modifying treatments 91Disease-slowing treatments will satisfy the most important unmet need of mild cognitive impairment 91Clinical trial design in mild cognitive impairment 91CHAPTER 6 POTENTIAL DISEASE SLOWING THERAPIES 92Overview for potentially disease-slowing therapies 93Definition of current comparator therapy - Aricept 94Aricept - a symptomatic drug prescribed off-label for the treatment of mild cognitive impairment 94Aricepts strengths and weaknesses 95Historical sales for Aricept and other anti-Alzheimers diseases drugs in mild cognitive impairment 95Factors required to compete with Aricept 96Bapineuzumab 97Drug overview 97Forecasts to 2018 97US - forecast methodology 985EU - forecast methodology 99Japan - forecast methodology 100Datamonitor drug assessment summary 100Pipeline Insight: Mild Cognitive Impairment - Unlocking the potential of prodromal Alzheimers disease and beyond Page 4/12
  • 5. Find Industry reports, Company profilesReportLinker and Market StatisticsMarketing factors 101Price of bapineuzumab and influencing factors 101Competitive environment 102Bapineuzumab market penetration 103Patient potential 104Potential limited to ApoE4 non-carriers with prodromal Alzheimers disease 104Intravenous administration and MRI monitoring 104Satisfaction of unmet needs 105Clinical trial data 105Positive post-hoc analysis results in ApoE-negative patients with mild-to-moderate Alzheimers disease patients 105Phase II clinical trial data 105Ongoing clinical trials 107LY450139 - semagacestat 108Drug overview 108Forecasts to 2018 108US - forecast methodology 1095EU - forecast methodology 110Japan - forecast methodology 111Datamonitor drug assessment summary 111Marketing factors 112Price for LY450139 and influencing factors 112LY450139 market penetration 113Competitive environment 113Patient potential 114LY450139s potential limited to MCI patients with prodromal Alzheimers disease symptoms 114Satisfaction of unmet needs 114Clinical trial data 114Ongoing and completed clinical trials 114Phase II results: reduction of beta-amyloid fragment (1-40) concentration in plasma but no change in cognition 116Gammagard 117Drug overview 117Gammagards large production may represent a challenge 118Forecasts to 2018 118US - forecast methodology 119Datamonitor drug assessment summary 120Marketing factors 121Price for Gammagard and influencing factors 121Gammagard market penetration 121Patient potential 122Gammagards potential possibly limited to prodromal Alzheimers disease MCI patients 122Satisfaction of unmet needs 122Clinical trial data 122Phase II clinical trial 122Ongoing Phase III clinical trial 124Rember 125Drug overview 125Forecasts to 2018 125US - forecast methodology 1265EU - forecast methodology 127Datamonitor drug assessment summary 127Pipeline Insight: Mild Cognitive Impairment - Unlocking the potential of prodromal Alzheimers disease and beyond Page 5/12
  • 6. Find Industry reports, Company profilesReportLinker and Market StatisticsMarketing factors 128Price for Rember and influencing factors 128Rember market penetration 129Patient potential 130Rember potential possibly limited to MCI patients with prodromal Alzheimers disease symptoms 130Satisfaction of unmet needs 130Clinical trial data 130A Phase IIb trial of a tau aggregation inhibitor therapy 130PBT2 133Drug overview 133Historical research program 133Forecasts to 2018 134US - forecast methodology 1345EU - forecast methodology 135Datamonitor drug assessment summary 136Marketing factors 137Price for PBT2 and influencing factors 137PBT2 market penetration 137Patient potential 138PBT2s potential limited to prodromal Alzheimers disease MCI patients 138Satisfaction of unmet needs 138Clinical trial data 138Higher dose of PBT2 proved to be safe and effective in early Alzheimers disease patients 138PBT2 - preclinical results 140AL-108 140Drug overview 140AL-108 - potential disease-slowing treatment for cognitive disorders 140AL-208 - the injectable formulation of NAP 141Partnership needed for further development in Alzheimers disease 141Projects for 2009 142Clinical trial data 142AL-108 demonstrated mixed results in amnestic MCI patients 142LY2062430 145Drug overview 145Clinical trial data 145Phase II clinical trial 145PF-04494700 (TTP488) 147Drug overview 147Clinical trial data 148Phase IIa clinical results 148Ongoing clinical trial program 149Rosiglitazone XR 149Drug overview 149Amyloid vaccines 150ACC-001 151Drug overview 151Ongoing clinical trial 151CAD106 152Drug overview 152Clinical trial 152Pipeline Insight: Mild Cognitive Impairment - Unlocking the potential of prodromal Alzheimers disease and beyond Page 6/12
  • 7. Find Industry reports, Company profilesReportLinker and Market StatisticsCHAPTER 7 SYMPTOMATIC TREATMENTS 154Overview for symptomatic drugs 155Definition of current comparator therapy - Aricept 156Dimebon 156Drug overview 156A promising therapy co-developed by Medivation and Pfizer 156Dimebons mechanism of action 157Forecasts to 2018 157US - forecast methodology 1585EU - forecast methodology 159Japan - forecast methodology 159Datamonitor drug assessment summary 160Marketing factors 161Modes of action may be confusing for prescribers 161Price for Dimebon and influencing factors 161Dimebon market penetration: potentially beneficial for the entire MCI population 161Pfizer - a highly valuable partner in Alzheimers disease and associated markets 162Patient potential 162Satisfaction of unmet needs 163Clinical trial data 163Impressive Phase II results in patient with mild-to-moderate Alzheimers disease 164Ongoing clinical trials 165Aricept (donepezil) SR 167Drug overview 167Forecasts to 2018 167US - forecast methodology 1685EU - forecast methodology 169Datamonitor drug assessment summary 169Marketing factors 170Price for Aricept (donepezil) SR 170Aricept SR market penetration expected to decline over the forecast period 171Patient potential 171Satisfaction of unmet needs 171SB-742457 171Drug overview 171Datamonitor comments 172BIBLIOGRAPHY 173Journals 173Websites 181Annual reports 186Datamonitor reports 187APPENDIX 188Methodology 188Datamonitor forecast methodology 188Patents expiry dates of key branded treatments 188Current market estimate 189Treatments for MCI 189Definition of a standard unit (only use if ForeSight model used to forecast) 189Epidemiology forecasts 189Pipeline product forecasts 190Pipeline Insight: Mild Cognitive Impairment - Unlocking the potential of prodromal Alzheimers disease and beyond Page 7/12
  • 8. Find Industry reports, Company profilesReportLinker and Market StatisticsContributing experts 192About Datamonitor 193About Datamonitor Healthcare 193Datamonitor Healthcares therapy area capabilities 194About the Disease analysis team 195Disclaimer 196List of TablesTable 1: Key parameters of mild cognitive impairment (MCI) across the seven major markets, 2007-2017 7Table 2: Key pipeline product sales in mild cognitive impairment (MCI) across the seven major markets to 2018 8Table 3: Key potential disease-slowing treatments in development for Alzheimers disease and potentially appropriate for mildcognitive impairment, 2009 16Table 4: Key symptomatic treatments in development for Alzheimers disease and potentially appropriate for mild cognitiveimpairment, 2009 17Table 5: Number of key late-stage pipeline drugs potentially suitable for mild cognitive impairment per class and phase ofdevelopment, 2009 18Table 6: Allon Therapeuticss drug pipeline, 2009 19Table 7: Prevalence of mild cognitive impairment (MCI) in the seven major markets, 2007 33Table 8: Epidemiological studies on mild cognitive impairment, 2001-08 33Table 9: Description of different types of dementias mild cognitive impairment patients can go on to develop 40Table 10: Mild cognitive impairment-specific sales value ($) and volume (IMS standard units, SU) and number of patients treatedacross the seven major markets, 2007 42Table 11: Examples of cerebrospinal fluid tracers for beta-amyloid plaques and acetylcholinesterase 56Table 12: Example of alternative tests to cerebrospinal fluid biomarkers in neurological conditions 57Figure 9: Unmet needs in mild cognitive impairment (MCI), 2009 62Table 13: ICD-10 codes excluded from mild cognitive impairment (MCI) sales estimate 71Table 14: Evolution of MCI patients flow across the seven major markets, 2007-2018 80Table 15: Sales forecasts for the key late-stage pipeline drugs across the seven major markets ($m), 2011-18 86Table 16: Key potential disease-slowing treatments in development for Alzheimers disease and potentially appropriate for mildcognitive impairment (MCI), 2009 93Table 17: Pfizer/Eisais Aricept: key facts, 2009 94Table 18: Bapineuzumab - forecast methodology in mild cognitive impairment in the US, 2012-18 99Table 19: Bapineuzumab - forecast methodology in mild cognitive impairment in the 5EU, 2012-18 99Table 20: Bapineuzumab - forecast assumptions in mild cognitive impairment in Japan, 2013-18 100Table 21: LY450139 - forecast methodology in mild cognitive impairment in the US, 2013-18 110Table 22: LY450139 - forecast methodology in mild cognitive impairment in the 5EU, 2013-18 110Table 23: LY450139 - forecast methodology in mild cognitive impairment in Japan, 2014-18 111Table 24: Clinical trial summary for LY450139 in Alzheimers disease, 2009 115Table 25: Gammagard - forecast methodology in mild cognitive impairment in the US, 2013-18 119Table 26: Rember - forecast methodology in mild cognitive impairment in the US, 2014-18 126Table 27: Rember - forecast methodology in mild cognitive impairment in the 5EU, 2014-18 127Table 28: PBT2 - forecast methodology in mild cognitive impairment in the US, 2014-18 135Table 29: PBT2 - forecast methodology in mild cognitive impairment in the 5EU, 2014-18 135Table 30: Clinical trial results for high dose of AL-108 (15mg twice a day) in mild cognitive impairment (MCI) subjects 143Table 31: Key symptomatic treatments in development for Alzheimers disease and potentially appropriate for mild cognitiveimpairment (MCI), 2009 155Table 32: Dimebon - forecast methodology in mild cognitive impairment in the US, 2012-18 158Table 33: Dimebon - forecast methodology in mild cognitive impairment in the 5EU, 2012-18 159Table 34: Dimebon - forecast methodology in mild cognitive impairment in Japan, 2015-18 160Table 35: Clinical trial summary for Dimebon in Alzheimers disease, 2009 166Table 36: Aricept (donepezil) SR - forecast methodology in mild cognitive impairment in the US, 2011-18 168Pipeline Insight: Mild Cognitive Impairment - Unlocking the potential of prodromal Alzheimers disease and beyond Page 8/12
  • 9. Find Industry reports, Company profilesReportLinker and Market StatisticsTable 37: Aricept (donepezil) SR - forecast methodology in mild cognitive impairment in the 5EU, 2011-18 169Table 38: Patents expiry dates of key branded anti-Alzheimers disease drugs across the US, the 5EU and Japan 188Table 39: Datamonitor drug assessment parameters 191List of FiguresFigure 1: Datamonitors drug assessment summary of key late-stage therapies in development for Alzheimers disease and potentiallyeffective in mild cognitive impairment, 2007-2018. 9Figure 2: Number of symptomatic and potential disease-slowing late-stage pipeline drugs potentially appropriate for mild cognitiveimpairment, 2009 15Figure 3: Diagnosis algorithm and mild cognitive impairment (MCI) segmentation according to clinical characterization of thesymptoms 27Figure 4: Mild cognitive impairment prevalence by age in Unverzagt et al.s study, 2001 35Figure 5: Prevalence of each subtype within the mild cognitive impairment (MCI) population 37Figure 6: Potential relation between symptom classification and outcomes in mild cognitive impairment patients 38Figure 7: Prevalent, diagnosed and treated population with mild cognitive impairment aged 65 and over across the seven majormarkets, 2007 43Figure 8: Segmentation of the mild cognitive impairment population and the treatable population across the seven major markets 45Figure 10: Datamonitors mild cognitive impairment (MCI) sales methodology, 2009 70Figure 11: US IMS diagnostic value sales ($m) for ATC classes N6D and N7D limited to non-dementia indications per age group,2007 72Figure 12: US IMS diagnostic value sales ($) for ATC classes N6D and N7D limited to non-dementia indications per 1,000 persons,2007 73Figure 13: Mild cognitive impairment (MCI)-specific sales value ($m) by class across the seven major markets, 2005-08 75Figure 14: Mild cognitive impairment (MCI)-specific sales volume (IMS standard units) by class across the seven major markets,2005-08 76Figure 15: Mild cognitive impairment (MCI)-specific sales revenue ($m) in the US, 5EU and Japan, 2007 77Figure 16: Datamonitors methodology for estimating the treatable MCI population across the seven major markets. 79Figure 17: Evolution of the mild cognitive impairment presentation and diagnosis combined rate across the seven major markets,2005-2018 82Figure 18: Number of mild cognitive impairment (MCI) patients treated by drug type across the seven major markets ($m), 2005-201883Figure 19: Mild cognitive impairment (MCI)-specific sales revenue distribution by drug type across the seven major markets ($m),2005-2018 84Figure 20: Sales forecasts for key mild cognitive impairment-specific late-stage pipeline drugs across the major markets, 2010-201885Figure 21: Datamonitors drug assessment summary of key late-stage therapies in development for Alzheimers disease andpotentially effective in mild cognitive impairment, 2007-2018 87Figure 22: Mild cognitive impairment patient potential according to the type of treatment 90Figure 23: Aricept (donepezil) - strengths and weaknesses, 2009 95Figure 24: Historical sales for the current anti-Alzheimers disease products in the mild cognitive impairment market across the sevenmajor markets, 2005-08 96Figure 25: Off-label sales forecast for bapineuzumab in mild cognitive impairment (MCI) to 2018 across the seven major markets 98Figure 26: Datamonitors competitive positioning analysis of bapineuzumab in mild cognitive impairment across the seven majormarkets, 2007-2018 101Figure 27: Off-label sales forecast for LY450139 in mild cognitive impairment to 2018 across the seven major markets 109Figure 28: Datamonitors competitive positioning analysis of LY450139 in mild cognitive impairment (MCI) across the seven majormarkets, 2007-2018 112Figure 29: Off-label sales forecast for Gammagard in mild cognitive impairment (MCI) to 2018 in the US 119Figure 30: Datamonitors competitive positioning analysis of Gammagard in mild cognitive impairment (MCI) across the seven majormarkets, 2007-2018 120Figure 31: Off-label sales forecast for Rember in mild cognitive impairment (MCI) to 2018 in the US and 5EU 126Pipeline Insight: Mild Cognitive Impairment - Unlocking the potential of prodromal Alzheimers disease and beyond Page 9/12
  • 10. Find Industry reports, Company profilesReportLinker and Market StatisticsFigure 32: Datamonitors competitive positioning analysis of Rember in mild cognitive impairment (MCI) across the seven majormarkets, 2007-2018 128Figure 33: Off-label sales forecast for PBT2 in mild cognitive impairment (MCI) to 2018 in the US and 5EU 134Figure 34: Datamonitors competitive positioning analysis of PBT2 in mild cognitive impairment (MCI) across the seven major markets,2007-2018 136Figure 35: Off-label sales forecast for Dimebon in mild cognitive impairment to across the seven major markets, 2012-2018 158Figure 36: Datamonitors competitive positioning analysis of Dimebon in mild cognitive impairment across the seven major markets,2007-2018 160Figure 37: Off-label sales forecast for Aricept (donepezil) SR in mild cognitive impairment (MCI) to 2018 in the US and 5EU 168Figure 38: Datamonitors competitive positioning analysis of Aricept (donepezil) SR in mild cognitive impairment (MCI) across theseven major markets, 2007-2018 170Figure 39: Datamonitors drug assessment summary of key late-stage therapies in development for Alzheimers disease andpotentially effective in mild cognitive impairment, 2007-2018 192Pipeline Insight: Mild Cognitive Impairment - Unlocking the potential of prodromal Alzheimers disease and beyond Page 10/12
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