Pipeline Insight: Epilepsy - Past successes hard to emulate in highly genericized market

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IntroductionSales of antiepileptic drugs totaled $3.5 billion in 2009 across the seven major markets (US, Japan, France, Germany, Italy, Spain and the UK). Datamonitor anticipates the combination of continuing strong historical growth dynamics and the uptake of the late-stage pipeline drugs to result in the market value peaking at $5.1 billion in 2017, after which a new wave of patent expiries hits the US.Scope*Analysis of current epilepsy treatments, unmet market needs and the impact of generics.*Review of the late-stage epilepsy pipeline, including analysis of key R&D company strategies.*In depth analysis of historic (20052009) and future (20102019) seven major market sales value dynamics.*Commercial and clinical assessment of key late-stage pipeline drugs, with key opinion leader comment and region-specific sales forecasts to 2019.HighlightsWith more convenient dosing and a purported improved safety profile over Trileptal and Tegretol, Stedesa (eslicarbazepine, Sepracor/Eisai) is forecast to become the best-selling pipeline antiepileptic drug. Factoring monotherapy approval and first-line use, epilepsy-specific sales are forecast to top $400m across the seven major markets by 2019.Rikelta (brivaracetam, UCB) is forecast to generate almost $375m by 2019. With to UCB's already extensive epilepsy portfolio, Datamonitor expects careful positioning will negate significant sales cannibalization. Use will be chiefly among refractory patients with partial seizures, with monotherapy approval important to commercial success.Three products are in late-stage development for the at-home management of acute seizures, a market dominated by Diastat (diazepam rectal gel, Valeant). With all seeking to provide an improved administration method, Ikano's intranasal midazolam (ITI-111) is set to become the new market leader with approximately $30m in sales by 2019.Reasons to Purchase*Analyze competitive environment at time of product launch.*Validate internal forecasts and market potential for pipeline products.*Identify licensing opportunities based on company portfolio and market needs.

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Pipeline Insight: Epilepsy - Past successes hard to emulate in highly genericized market

  1. 1. Find Industry reports, Company profilesReportLinker and Market Statistics >> Get this Report Now by email!Pipeline Insight: Epilepsy - Past successes hard to emulate in highlygenericized marketPublished on May 2010 Report SummaryIntroductionSales of antiepileptic drugs totaled $3.5 billion in 2009 across the seven major markets (US, Japan, France, Germany, Italy, Spainand the UK). Datamonitor anticipates the combination of continuing strong historical growth dynamics and the uptake of the late-stagepipeline drugs to result in the market value peaking at $5.1 billion in 2017, after which a new wave of patent expiries hits the US.Scope*Analysis of current epilepsy treatments, unmet market needs and the impact of generics.*Review of the late-stage epilepsy pipeline, including analysis of key R&D company strategies.*In depth analysis of historic (20052009) and future (20102019) seven major market sales value dynamics.*Commercial and clinical assessment of key late-stage pipeline drugs, with key opinion leader comment and region-specific salesforecasts to 2019.HighlightsWith more convenient dosing and a purported improved safety profile over Trileptal and Tegretol, Stedesa (eslicarbazepine,Sepracor/Eisai) is forecast to become the best-selling pipeline antiepileptic drug. Factoring monotherapy approval and first-line use,epilepsy-specific sales are forecast to top $400m across the seven major markets by 2019.Rikelta (brivaracetam, UCB) is forecast to generate almost $375m by 2019. With to UCBs already extensive epilepsy portfolio,Datamonitor expects careful positioning will negate significant sales cannibalization. Use will be chiefly among refractory patients withpartial seizures, with monotherapy approval important to commercial success.Three products are in late-stage development for the at-home management of acute seizures, a market dominated by Diastat(diazepam rectal gel, Valeant). With all seeking to provide an improved administration method, Ikanos intranasal midazolam (ITI-111)is set to become the new market leader with approximately $30m in sales by 2019.Reasons to Purchase*Analyze competitive environment at time of product launch.*Validate internal forecasts and market potential for pipeline products.*Identify licensing opportunities based on company portfolio and market needs.Pipeline Insight: Epilepsy - Past successes hard to emulate in highly genericized market Page 1/11
  2. 2. Find Industry reports, Company profilesReportLinker and Market Statistics Table of ContentOverview 1Catalyst 1Summary 1About Datamonitor Healthcare 2About the central nervous system pharmaceutical analysis team 2Executive Summary 3Strategic scoping and focus 3Datamonitor insight into the epilepsy market 3Related reports 5Upcoming related reports 5Table of Contents 61. Pipeline Overview and Dynamics 7Key findings 7Pipeline overview 8Epilepsy pipeline shows moderate innovation 8Classification of pipeline products 9GABA enhancers and ion channel modulators account for two-thirds of the late-stage epilepsy pipeline 9Investigated epilepsy types for each key pipeline drug 10Adjunctive therapy for refractory partial seizures is typically the initial indication 10Comparative forecasts 11Pipeline compounds from traditional classes to boost market sales 11Late-stage compounds in development set to achieve significant market share 12Datamonitors pipeline assessment summary 14Keppra remains the drug to beat, even 10 years after initial approval 14Key companies involved in the epilepsy pipeline 14UCB 15A novel mode of action and specific focus on epilepsy was a winning strategy for UCB 15UCBs market leader status in epilepsy will be maintained by reformulations and successors to Keppra 16Eisai 16Eisai follows a strategy of in-licensing antiepileptic drugs 16Key R&D company strategies 17Reformulations 17Extended-release formulations have dominated historical drug delivery advancements 17Minor chemical alterations are employed to improve efficacy or reduce side effect issues 17Indication expansion 18Monotherapy approval remains ultimate goal but niche pediatric indications represent additional opportunities 18Targeting additional central nervous system therapeutic indications is a common strategy 18Bipolar disorder and neuropathic pain markets prove lucrative for antiepileptic drugs 192. Disease Overview - Market Potential 21Key findings 21Definition 22Etiology of epilepsy 22Diagnosis of epilepsy 23Patient segmentation 24Pipeline Insight: Epilepsy - Past successes hard to emulate in highly genericized market Page 2/11
  3. 3. Find Industry reports, Company profilesReportLinker and Market StatisticsSeizures are categorized according to their location of origin 24Incidence of epilepsy 25There is little difference in the prevalence of partial and generalized epilepsy 25Incidence of epilepsy peaks in early and later years of life 26Epidemiology 27Seven major markets 28Almost 5 million individuals are estimated to suffer from epilepsy in the seven major markets 28Rest of the world 29China and India both have sizable epileptic populations each in excess of 6 billion 29Current treatment options 30A plethora of antiepileptic drugs are available but no true broad spectrum agent exists 30Impact of generic erosion 33The switching of stable epilepsy patients to a generic alternative remains controversial 33Switching between multiple generic formulations poses a danger 33Generic antiepileptic drugs-when used correctly-offer a benefit 34Current gold standard and comparator therapies 35Keppra shows broad spectrum activity and a strong safety profile 35Current market overview 38Epilepsy market struck by US patent expiry of key brands 38Total market volume increases despite drop in value 39Antiepileptic drugs fall broadly into two classes based on growth rate 40Unmet needs in epilepsy 41Unmet need 1: efficacious treatments for refractory epilepsy 42Unmet need 2: reduction in adverse side effects 43Unmet need 3: greater understanding of pediatric epilepsy 45Unmet need 4: greater treatment options for elderly patients 45Unmet need 5: compliance 46Target product profile versus current level of attainment 463. R&D Approach 49Key findings 49Clinical trial design in epilepsy 50Add-on studies are the mainstay of clinical trial design 50Clinical trial endpoints in epilepsy 51Other measures focus on wider aspects of life quality 51Post-marketing studies are important for detecting rare adverse events 52Key difficulties in epilepsy clinical trials 53Heterogeneity of disease 53Wide use of patients self-reporting 53Applicability of trial results to the elderly population 53Japanese clinical trials 53Changing clinical trials methods contribute to a chasm between Japanese and Western epilepsy markets 53Clinical trial design guidance from the EMA 54The typical Phase III clinical trial 554. Pipeline Analysis & Forecasts: Ion channel modulators 56Key findings 56Overview for ion channel modulators 57Pipeline summary 57Comparative forecasts 59Stedesa/Zebinix (eslicarbazepine acetate, Sepracor/Eisai/Bial Group) 60Drug overview 60Pipeline Insight: Epilepsy - Past successes hard to emulate in highly genericized market Page 3/11
  4. 4. Find Industry reports, Company profilesReportLinker and Market StatisticsUS approval expected to follow 2009 EU approval 60Drug profile 61Clinical trial data 61Stedesa has demonstrated impressive efficacy in reducing partial-onset seizures in refractory patients 61SWOT analysis 63Datamonitors drug assessment scorecard for Stedesa 63Clinical and commercial attractiveness 65Despite strong trial results, Stedesa may suffer from heavy competition and the lack of distinction from the other dibenzazepines 65Satisfaction of unmet needs 66Stedesa will offer clear benefit should trial results transpire in practice 66Forecasts to 2019 67Stedesa set to achieve significant commercial success, dependent on monotherapy approval 67Retigabine (D-23129, Valeant Pharmaceuticals/GlaxoSmithKline) 68Drug overview 68First-in-class ion channel modulator retigabine is pending approval in US and Europe 68Drug profile 69Clinical trial data 69Despite high discontinuation rate, retigabine responded "almost ideally" in Phase III clinical trials 69SWOT analysis 71Datamonitors drug assessment scorecard for retigabine 72Clinical and commercial attractiveness 73High incidence of minor side effects and three-times daily dosing offsets promising efficacy 73Satisfaction of unmet needs 74Retigabine offers benefit for treatment-refractory patients 74Forecasts to 2019 74Sizable market share for retigabine despite use being limited to adjunctive therapy 74Epliga (controlled-release oxcarbazepine, Supernus Pharmaceuticals) 76Drug overview 76Supernus claims alleviation of side effects and more convenient dosing for Epliga over Trileptal 76Drug profile 77Clinical trial data 77Lack of publicly available clinical data for Epliga 77SWOT analysis 79Datamonitors drug assessment scorecard for Epliga 80Clinical and commercial attractiveness 81Epligas appeal is heavily affected by lack of novelty and strong competition 81Satisfaction of unmet needs 82Epliga provides little breakthrough in the current treatment paradigm 82Forecasts to 2019 82Epliga to occupy small niche in market 82Other drugs in ion channel modulation 84Captisol-enabled fosphenytoin (CyDex Pharmaceuticals) 84Late-stage development compounds recently discontinued 84Comfyde (carisbamate, Johnson & Johnson) 84Key early-stage compounds in ion channel modulation 85ICA-105665 (Icagen) 85Retigabine MR (Valeant Pharmaceuticals) 85Elpetrigine (JZP-4, Jazz Pharmaceuticals) 855. Pipeline Analysis & Forecasts: Glutamate modulators 86Key findings 86Pipeline Insight: Epilepsy - Past successes hard to emulate in highly genericized market Page 4/11
  5. 5. Find Industry reports, Company profilesReportLinker and Market StatisticsOverview for glutamate receptor modulators 87Pipeline summary 87Comparative forecast 89Perampanel (E2007, Eisai) 90Drug overview 90Global development of novel AMPA receptor antagonist perampanel in full swing 90Drug profile 91Clinical trial data 91Strong efficacy data but safety results conspicuous by their absence 91SWOT analysis 93Datamonitors drug assessment scorecard for perampanel 94Clinical and commercial attractiveness 95Perampanel is commercially appealing but the spotlight remains on its safety 95Satisfaction of unmet needs 96Perampanel seeks to address efficacy among refractory patients 96Forecasts to 2019 96Steady uptake of perampanel helped by geographical expansion 96Other drugs in glutamate modulation 97Topiramate reformulations 97Late-stage development compounds recently discontinued 98Talampanel (Eli Lilly, Teva Pharmaceuticals) 98Key early-stage compounds in glutamate modulation 98BGG492 (Novartis) 986. Pipeline Analysis & Forecasts: GABA modulators 99Key findings 99Overview for GABA receptor modulation 100Pipeline summary 101Comparative forecast 102Ganaxolone (Marinus Pharmaceuticals) 103Drug overview 103Innovative neurosteroid has potential broad-spectrum efficacy in epilepsy 103Drug profile 104Clinical trial data 104Synthetic neurosteroid ganaxolone is well tolerated 104SWOT analysis 106Datamonitors drug assessment scorecard for ganaxolone 107Clinical and commercial attractiveness 108Novelty should entice potential partners 108Satisfaction of unmet needs 109Ganaxolone shows a strong safety profile and may hold promise for refractory patients 109Forecasts to 2019 109Secondary indication to boost ganaxolone uptake 109Late-stage development compounds recently discontinued 110DP-VPA 110Key early-stage compounds in GABA modulation 111T2007 (sodium diphenyl barbiturate, Taro Pharmaceuticals) 1117. Pipeline Analysis & Forecasts: Other antiepileptic drugs 112Key findings 112Overview for other antiepileptic drugs 113Pipeline summary 113Pipeline Insight: Epilepsy - Past successes hard to emulate in highly genericized market Page 5/11
  6. 6. Find Industry reports, Company profilesReportLinker and Market StatisticsComparative forecast 114Rikelta (brivaracetam, UCB) 115Drug overview 115Rikelta is a second-generation SV2A ligand 115Drug profile 116Clinical trial data 116Rikeltas progress slowed by mixed Phase III trial results 116SWOT analysis 118Datamonitors drug assessment scorecard for Rikelta 119Clinical and commercial attractiveness 120Rikelta will benefit from the positive image of UCB among neurologists, but needs to differentiate from Keppra 120Satisfaction of unmet needs 121Further clinical trials will expose Rikeltas potential in refractory patients 121Forecasts to 2019 122Strong sales but Rikeltas potential not fully realized 122Late-stage development compounds recently discontinued 123Seletracetam (UCB) 123Key other early-stage compounds 123VX-765 (Vertex Pharmaceuticals) 123JNJ-26489112 (Johnson & Johnson) 124YKP3089 (SK Life Science) 1248. Pipeline Analysis & Forecasts: Acute epilepsy treatments 125Key findings 125Overview of acute epilepsy management 126Acute seizures are a serious medical crisis 126Gold standard for acute epilepsy management 126Diastat (diazepam rectal gel, Valeant) 126Unmet need in acute treatment of epilepsy 127Undesirable delivery of diazepam represents an unmet need in the acute setting 127Alternative methods for drug delivery 128Intranasal delivery is convenient, easy-to-use, effective and fast-acting 128Auto-injectors provide a reliable intramuscular route 128Pipeline summary 129Comparative forecast 130ITI-111 (midazolam intranasal, Ikano Therapeutics) 131Drug overview 131Datamonitor drug assessment scorecard for ITI-111 132Forecasts to 2019 132First-to-market ITI-111 to experience strong uptake 132JZP-8 (clonazepam intranasal, Jazz Pharmaceuticals) 133Drug overview 133Datamonitor drug assessment scorecard for JZP-8 134Forecasts to 2019 135Second-best for alternative intranasal treatment 135Vanquix (diazepam auto-injection, King Pharmaceuticals) 136Drug overview 136Datamonitors drug assessment scorecard for Vanquix 137Forecasts to 2019 137Success of Vanquix dependent on caregiver appeal of intramuscular injection 1379. Innovative Early-Stage Approaches 139Pipeline Insight: Epilepsy - Past successes hard to emulate in highly genericized market Page 6/11
  7. 7. Find Industry reports, Company profilesReportLinker and Market StatisticsKey findings 139Medical devices in epilepsy 140Vagus nerve stimulation 140Cyberonics has produced the pioneering medical device in epilepsy 140Deep brain stimulation of thalamus 141Medtronics device is nearing FDA approval 141Responsive neurostimulation 142Innovative new system responds only to abnormal electric activity in addition to providing diagnostic information 142Intracranial drug delivery 142Targeted drug delivery could reduce broad side-effects associated with current drug therapies 142Future direction of epilepsy pharmacotherapy 143Metabolic regulation provides novel mode of action for small molecules 1432-deoxy-D-glucose (NeuroGenomeX) 143Gene therapy can capitalize on endogenous seizure control systems 145Galanin (Asklepios BioPharmaceutical) 145Neuropeptide Y (Neurologix) 146Neuropeptides can be modified to improve pharmacokinetic profile 146NAX-5055 (NeuroAdjuvants) 146Adenosine-releasing implants 146Localized delivery avoids systemic side effects 146Bibliography 148Journal articles and conference abstracts 148Websites 156Datamonitor reports 158APPENDIX 159Methodology 159Epidemiology estimate 159Definition of epilepsy market 159Product forecasts 160Sales calculations 160Definition of a standard unit 160Datamonitors drug assessment scorecard 161Contributing experts 162About Datamonitor 163About Datamonitor Healthcare 163About the Disease analysis team 163Datamonitor consulting 164Disclaimer 166List of TablesTable 1: Key late-stage pipeline products in development for epilepsy, 2010 8Table 2: Investigated epilepsy types for key pipeline antiepileptic drugs, 2010 11Table 3: Sales forecasts for pipeline products in epilepsy in the seven major markets ($m), 2010-19 12Table 4: UCBs antiepileptic drug portfolio, 2010 15Table 5: Eisais antiepileptic drug portfolio, 2010 16Table 6: Different seizure types and their typical characteristics 24Table 7: Prevalence of active epilepsy in the seven major markets (000s), 2010 28Table 8: Prevalence of epilepsy in the BRIC nations, Turkey and Canada (000s), 2010 29Table 9: Leading treatment options for epilepsy, 2010 31Table 10: Total healthcare costs of topiramate users, 2009 34Table 11: Keppra (levetiracetam) - drug profile, 2010 36Pipeline Insight: Epilepsy - Past successes hard to emulate in highly genericized market Page 7/11
  8. 8. Find Industry reports, Company profilesReportLinker and Market StatisticsTable 12: Ability of current class comparator to meet unmet needs in epilepsy, 2010 48Table 13: Typical Phase III clinical trial design in epilepsy 55Table 14: Ion channel modulator drugs in late-stage development for epilepsy, 2010 59Table 15: Sales forecasts for ion channel modulators in development for epilepsy in the seven major markets ($m), 2010-19 59Table 16: Stedesa - drug profile, 2010 61Table 17: Phase III clinical trials for eslicarbazepine acetate, 2008 62Table 18: Datamonitors drug assessment scorecard for Stedesa in epilepsy, 2010 65Table 19: Sales forecasts for Stedesa in the seven major markets ($m), 2010-19 67Table 20: Impacting factors on the revenue of Stedesa, 2010-19 68Table 21: Retigabine - drug profile, 2010 69Table 22: Phase III trial data for retigabine, 2008 70Table 23: Datamonitors drug assessment scorecard for retigabine in epilepsy, 2010 73Table 24: Sales forecasts for retigabine in the seven major markets ($m), 2010-19 75Table 25: Impacting factors on the revenue of retigabine, 2010-19 75Table 26: Epliga - drug profile, 2010 77Table 27: Key facts: Phase III trial of Epliga, 2010 78Table 28: Datamonitors drug assessment scorecard for Epliga in epilepsy, 2010 81Table 29: Sales forecasts for Epliga in the seven major markets ($m), 2010-19 83Table 30: Impacting factors on the revenue of Epliga, 2010-19 83Table 31: Glutamate modulator drugs in late-stage development for epilepsy, 2010 89Table 32: Sales forecasts for glutamate modulators in development for epilepsy in the seven major markets ($m), 2010-19 89Table 33: Perampanel - drug profile, 2010 91Table 34: Key facts: Phase III trial of perampanel, 2010 92Table 35: Datamonitors drug assessment scorecard for perampanel in epilepsy, 2010 95Table 36: Sales forecasts for perampanel in the seven major markets ($m), 2010-19 96Table 37: Impacting factors on the revenue of perampanel, 2010-19 97Table 38: GABA modulator drug in late-stage development for epilepsy, 2010 102Table 39: Sales forecasts for GABA modulators in development for epilepsy in the seven major markets ($m), 2010-19 102Table 40: Ganaxolone - drug profile, 2010 104Table 41: Key facts: Phase II trial of ganaxolone, 2010 105Table 42: Datamonitors drug assessment scorecard for ganaxolone in epilepsy, 2010 108Table 43: Sales forecasts for ganaxolone in the seven major markets ($m), 2010-19 110Table 44: Impacting factors on the revenue of ganaxolone, 2010-19 110Table 45: Other drugs in late-stage development for epilepsy, 2010 114Table 46: Sales forecasts for other drugs in development for epilepsy in the seven major markets ($m), 2010-19 114Table 47: Rikelta - drug profile, 2010 116Table 48: Phase II clinical trials for Rikelta, 2006 117Table 49: Datamonitors drug assessment scorecard for Rikelta in epilepsy, 2010 120Table 50: Sales forecasts for Rikelta in the seven major markets ($m), 2010-192010-19 122Table 51: Impacting factors on the revenue of Rikelta, 2010-19 123Table 52: Diastat (diazepam rectal gel) - drug profile, 2010 127Table 53: Treatments in late-stage development for acute epilepsy management, 2010 130Table 54: Sales forecasts for pipeline products in epilepsy in the US ($m), 2010-19 130Table 55: Datamonitors drug assessment scorecard for ITI-111 in acute epilepsy, 2010 132Table 56: Sales forecasts for ITI-111 in the seven major markets ($m), 2010-19 133Table 57: Impacting factors on the revenue of ITI-111, 2010-19 133Table 58: Datamonitors drug assessment scorecard for JZP-8 in acute epilepsy, 2010 134Table 59: Sales forecasts for JZP-8 in the seven major markets ($m), 2010-19 135Table 60: Impacting factors on the revenue of JZP-8, 2010-19 135Table 61: Datamonitors drug assessment scorecard for Vanquix in acute epilepsy, 2010 137Pipeline Insight: Epilepsy - Past successes hard to emulate in highly genericized market Page 8/11
  9. 9. Find Industry reports, Company profilesReportLinker and Market StatisticsTable 62: Sales forecasts for Vanquix in the seven major markets ($m), 2010-19 138Table 63: Impacting factors on the revenue of Vanquix, 2010-19 138Table 64: ICD-10 codes used to define the epilepsy market 159Table 65: Datamonitors drug assessment parameters for key late-stage epilepsy pipeline therapies 161Table 66: Datamonitors drug assessment parameters for key late-stage acute epilepsy pipeline therapies 162List of FiguresFigure 1: Late-stage epilepsy pipeline products by mode of action, 2010 9Figure 2: Typical modes of action in epilepsy pharmacotherapy 10Figure 3: Epilepsy-specific sales, historical and forecast to 2019, across the seven major markets 13Figure 4: Datamonitors pipeline assessment summary for epilepsy, 2010 14Figure 5: Additional indications of key approved and pipeline antiepileptic drugs, 2010 19Figure 6: Incidence of epilepsy by seizure type 26Figure 7: Incidence of epilepsy in different age groups 27Figure 8: Epilepsy population in Brazil, India, China and the US, 2010 30Figure 9: Epilepsy-specific sales value ($ billion) in the seven major markets by region, 2005-2009 38Figure 10: Epilepsy-specific sales volume (billion SUs) in the seven major markets by region, 2005-2009 39Figure 11: Epilepsy market mean prices split by region in the seven major markets, 2005-2009 40Figure 12: Performance of the top 10 brands in the seven major markets ($m), 2005-09 41Figure 13: Key unmet needs for epilepsy, 2010 42Figure 14: Ion channel modulators as antiepileptic drugs 57Figure 15: Datamonitors pipeline assessment summary for ion channel modulators in epilepsy, 2010 58Figure 16: Stedesa - SWOT analysis, 2010 63Figure 17: Datamonitors drug assessment summary for Stedesa in epilepsy, 2010 64Figure 18: Retigabine - SWOT analysis, 2010 71Figure 19: Datamonitors drug assessment summary for retigabine in epilepsy, 2010 72Figure 20: Epliga - SWOT analysis, 2010 79Figure 21: Datamonitors drug assessment summary for Epliga in epilepsy, 2010 80Figure 22: Glutamate receptor modulators as antiepileptic drugs 87Figure 23: Datamonitors drug assessment summary for glutamate modulators in epilepsy, 2010 88Figure 24: Perampanel - SWOT analysis, 2010 93Figure 25: Datamonitors drug assessment summary for perampanel in epilepsy, 2010 94Figure 26: GABA receptor modulators as antiepileptic drugs 100Figure 27: Datamonitors drug assessment summary for ganaxolone in epilepsy, 2010 101Figure 28: Ganaxolone - SWOT analysis, 2010 106Figure 29: Datamonitors drug assessment summary for ganaxolone in epilepsy, 2010 107Figure 30: Datamonitors drug assessment summary for other drugs in development for epilepsy, 2010 113Figure 31: Rikelta - SWOT analysis, 2010 118Figure 32: Datamonitors drug assessment summary for Rikelta in epilepsy, 2010 119Figure 33: Datamonitors pipeline assessment summary for acute antiepileptic therapies in epilepsy, 2010 129Figure 34: Possible inhibition of kindling progression by 2-deoxy-D-glucose in epilepsy 144Figure 35: Design of adenosine-releasing implants 147Pipeline Insight: Epilepsy - Past successes hard to emulate in highly genericized market Page 9/11
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