Neuroscience has undergone a lot of ups and downs over the years, but it is now on the up. Johan Luthman, Executive Vice President of R&D at Lundbeck, gave a jam-packed and in-depth overview of the neuroscience field.
One in eight people is living with a mental health disorder, and neurology is a leading cause of disability and the second leading cause of death. Despite these challenging statistics, Luthman explained that there has been a significant increase in neuroscience drug approvals, with neurology consistently ranking among the top three therapeutic areas for new FDA approvals in recent years.
Nowadays, there is a lot of promising biology to work on and a rapidly expanding target landscape at scientists’ disposal. Luthman commented that there is a notable lag between increased academic funding in neuroscience and industry investment, with pharma companies still heavily favouring oncology despite neuroscience's growing success in drug approvals.
He added that there is more biomarker-based development nowadays, which has resulted in accelerated approvals in neuroscience. For example, amyloid PET and neurofilament light chains are key biomarkers with increased potential for early de-risking and accelerated approval. Examples of accelerated drug approvals within neuroscience include A-beta mAbs for Alzheimer’s disease and ASO treatments for Duchenne muscular dystrophy and ALS. However, oncology has clearly dominated the field of accelerated approvals over the last decade.
Moving on, Luthman went on to discuss breakthroughs in specific diseases. Lecanemab and Rexulti are new treatments for Alzheimer’s disease. Luthman suggested that Rexulti is often overlooked, but it is the first treatment for behavioural and psychological symptoms in dementia to receive approval in the US. There have also been some steps forward in migraine prevention, with the PACAP mechanism displaying treatment efficacy, which has opened doors for neuropeptide modulation. Furthermore, rare neurological diseases such as multiple system atrophy and Dravet syndrome have seen advancements driven by biomarker-based and mechanistically targeted therapies.
Although notable progress has been made in the field of neuroscience, challenges remain in translating preclinical models to human outcomes, especially in psychiatry. Like all therapeutic areas, there is a call for more rigorous early-stage attrition to improve success rates in drug development.
