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Obesity Drug Discovery: Success and Challenges for a New Pharmaceutical Market
Decision Resources, Inc., June 2005, Pages: 18


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In recent years, obesity has become a major health problem for many postindustrial societies, so much so that in 2004, the United States Health and Human Services declared obesity to be a disease. Obesity poses a major health risk because it greatly increases the risk of comorbidities such as diabetes, cardiovascular diseases, arthritis, and cancer. Recognizing the potential for a new blockbuster market, major pharmaceutical companies have increasingly focused on obesity and its causes, in the process identifying many potential targets and pathways that could be exploited to create novel therapies. Studies on the molecular mechanisms involved in obesity are revealing a complex set of pathways, feedback loops, hormones, and metabolites that integrate multiple physiological systems in the brain, gastrointestinal system, endocrine system, and metabolic systems. The challenge for obesity drug discovery is that drugs must compete against powerful physiological and behavioral factors that have been selected by evolution to favor feeding and energy storage.

In this report, we provide a detailed discussion of the mechanics of obesity and its comorbidities, as well as the targets and pathways identified as points of intervention by investigational obesity drugs. We will also examine directions being pursued in obesity research and development and corporate alliances and activities in the field.

Business Implications
- The prevalence of obesity has increased dramatically in the last ten years, prompting the Centers for Disease Control and Prevention to describe obesity as an epidemic. Obesity increases predisposition to various diseases, including diabetes, cardiovascular diseases, and cancer. In 2004, the United States Health and Human Services declared obesity to be a disease, creating important changes to Medicare and health care reimbursement policy for obesity-related therapies.

- Obesity has increasingly become the focus of major pharmaceutical companies as they recognize the potential for a new blockbuster market. Rimonabant, a drug that regulates appetite, is in Phase III clinical trials. Companies are also forming high-value alliances, including target and lead identification deals, with biotech companies for obesity drug discovery.

- Research into the causes of obesity has identified many potential targets and pathways that could be exploited to create novel therapies. New investigational obesity drugs and drug targets can be generally categorized into those that regulate appetite, lipid metabolism, and adipocytes or their signals. Obesity research is still in its infancy, and researchers are likely to identify many new potential targets and therapeutic approaches.

- Because obesity therapy is a preventive therapy for otherwise outwardly healthy people, patients and regulatory agencies will not tolerate unacceptable medium-to-long-term side effects. Companies must develop therapies with side effects that are not worse than the obesity-related comorbidities the drugs are trying to prevent. Another challenge for long-term obesity therapy is simply to overcome the evolutionary selection of multiple physiological and metabolic responses that favor appetite and fat storage.



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