"The dynamics of the multiple system atrophy treatment market is anticipated to change during the forecast period as companies across the 7MM are diligently working towards the development of novel treatment options to combat the existing treatment-based unmet needs. Key players, such as Theravance Biopharm, H Lundbeck A/S, Alterity Therapeutics, AskBio, Ionis Pharmaceuticals/Biogen, and others are involved actively in developing potential treatment scopes. Multiple system atrophy (MSA) is a rare neurological disorder that leads to the progressive deterioration of nerve cells in the brain, impacting both the autonomic nervous system and motor control. This progression disrupts vital functions, including breathing, digestion, and bladder control.
According to DelveInsight's estimates, in 2023, there were approximately 71,800 prevalent cases of MSA in the 7MM. Of these, the US accounted for 60% of the cases. According to the estimates, in 2023 there were around 56,600 nOH symptomatic cases of MSA in the 7MM.
The current therapeutic management of MSA is based on symptomatic treatment and has witnessed little change for a decade. No specific neuroprotective treatment is available so far, leaving a survival time of usually less than 10 years after the diagnosis is made.
Learn more about the MSA treatment landscape @ Drugs for Multiple System Atrophy Treatment
NORTHERA (droxidopa) is the first approved treatment for symptomatic neurogenic orthostatic hypotension (nOH), a condition affecting 66-90% of patients with multiple system atrophy and contributing significantly to disability and injuries in these individuals. In 2006, Chelsea Therapeutics International acquired the drug's license from Dainippon Sumitomo Pharma. The US FDA granted accelerated approval for NORTHERA in February 2014 for its symptomatic benefits in adult patients with nOH. However, the drug lost its exclusivity in February 2021.
The drug used to treat Parkinson's disease, most notably levodopa (SINEMET), is also prescribed for MSA individuals. However, the efficacy of such medications varies greatly among the affected individuals. In addition to levodopa, other medications commonly used to treat Parkinson's disease may also be prescribed for individuals with MSA. These include dopamine agonists like ropinirole (Requip) and pramipexole (Mirapexin), which enhance the activity of dopamine receptors in the brain, aiding in the transmission of dopamine signals.
Midodrine hydrochloride (ProAmatine) is commonly used to manage low blood pressure, which can sometimes be linked to MSA. Other adrenergic drugs, such as ephedrine, may also help address low blood pressure, while L-threo-dihydroxyphenylserine (L-DOPS or L-threo-DOPS) is another option for treatment.
For symptoms like urinary issues and erectile dysfunction (ED), which often appear early in men with MSA, medications such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra) may be prescribed. MSA is typically treated with a mix of off-label and generic drugs, including clonazepam, vitamin E, propranolol, baclofen, and amantadine, which have shown improved efficacy. Additionally, N-acetyl cysteine, a precursor to the antioxidant glutathione, may offer potential benefits by modulating glutamatergic, neurotrophic, and inflammatory pathways.