Alzheimer's Disease is a new Decision Resources study that identifies and evaluates emerging therapies and treatment trends that will have a significant influence on this market over a 2000-2010 study period.

  (Photo: NewsCom: )    Acetylcholinesterase Inhibitors Continue to Dominate Market 

Acetylcholinesterase inhibitors (AChEIs) are the best-selling agents for AD because they have proved effective in slowing cognitive decline relative to placebo for at least one year. Although AChEIs are not effective for all AD patients, they will continue nonetheless to dominate the market over the 2000- 2010 forecast period of this study. Once-daily donepezil (Eisai/Pfizer's Aricept) is the current market leader in this class, and is likely to remain so despite competition from newer market entries largely because of its early- to-market advantage and its ease of use.

Exelon and Reminyl Will Rival Aricept for Top Position

Two newer AChEIs-rivastigmine (Novartis's Exelon) and galantamine (Shire/Janssen's Reminyl)-are expected to grow the class as a whole while taking significant market share from donepezil. Both agents tout additional potentially beneficial mechanisms of action, and, like donepezil, are being investigated for severe AD, other dementias, and mild cognitive impairment. Unlike donepezil, both of these AChEIs are available in oral solution, which may prove advantageous for administration to more severe AD patients who may have difficulty swallowing.

Rivastigmine's efficacy appears broadly comparable to that of the other AChEIs, although physicians interviewed generally believe that the optimal 12 milligram dose of rivastigmine is slightly more effective than the 10 mg dose of donepezil, the number of patients who can tolerate this dose is small. At other therapeutic doses, the efficacy of rivastigmine is broadly comparable to other AChEIs. In addition, physicians, especially general practitioners, find rivastigmine's titration schedule burdensome. In June 2001, Novartis announced plans to conduct a head-to-head clinical trial comparing rivastigmine and donepezil.

Galantamine exhibits broad based efficacy on functional activities, behavior and caregiver burden, which compares favorably with the other AChEIs. Like rivastigmine, galantamine is dosed twice daily and, like rivastigmine, has a stepped titration phase to achieve optimal dosing. If the drug is titrated according to the label its side effect profile is at least as favorable as comparable to those of the other two drugs.

Alzheimer's Disease offers invaluable market intelligence for pharmaceutical companies competing in this market and is a part of Cognos, one of six Pharmacor services available from Decision Resources that evaluate the commercial potential of drugs in research and development.

Decision Resources, Inc., is a world leader in research publications and advisory services designed to help clients shape strategy, allocate resources, and master their chosen markets. Founded as a subsidiary of Arthur D. Little, Inc., the company has provided strategic information services for 30 years, assessing international pharmaceutical and health care industry trends. Visit Decision Resources at

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SOURCE: Decision Resources, Inc.

Contact: Frank Sama of Decision Resources, Inc., +1-781-296-2553,