Significant Patient Need in Advanced Parkinson’s Disease

Parkinson’s disease (PD) is a progressive disorder characterized by a diminished production of dopamine in a specific area of the brain called substantia nigra. According to the Parkinson's Foundation, PD is the second most common neurodegenerative disorder, after Alzheimer's disease, affecting nearly one million people in the United States. This number is expected to rise to 1.2 million by 2030. Incidence of the disease increases with age, but an estimated four percent of people with PD are diagnosed before age 50. Men are 1.5 times more likely to have Parkinson's than women. The estimated healthcare costs related to the disease in the U.S. alone, including treatment, social security payments and lost income, are nearly $52 billion per year.

 

Symptoms of PD involve movement (motor) and non-movement (non-motor) disability such as bradykinesia (slow movement), tremor, rigidity (stiffness), postural instability, depression and sleep disturbance. These symptoms generally develop slowly over years and vary by individual eventually becoming more severe over time, creating a complex clinical picture.

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Disease Progression Occurs Over Time

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Though PD remains largely idiopathic, increasing evidence from recent studies suggest a possible linkage between the gut (the gastrointestinal system) and PD. The current theory (part of Braak's hypothesis) is that accumulation in the brain of the protein alpha-synuclein -- a hallmark of the disease -- occurs in nerve cells of the olfactory bulb, which controls sense of smell, and the medulla in the brainstem. With disease progression, the protein aggregates also develop in the substantia nigra and the cortex over time. Under the Braak theory, the protein aggregation could begin in the nervous system of the gastrointestinal tract and migrate to the central nervous system.

 

There are different stages of PD defined by typical patterns of progression and the severity of symptoms over the years. Not everyone will experience all the symptoms of the disease nor will they experience them in the same order or level of intensity.