Neurodegenerative disorders, psychiatric diseases, and pain
Neurodegenerative disorders, psychiatric diseases, and pain are our three main areas of focus.  Each of these areas is distinguished by a number of major, unanswered medical needs.

Neurodegenerative disorders—those that cause the nervous system to gradually degenerate—take an extraordinary toll on patients, their families and society as a whole. Patients with Alzheimer’s disease, for example, need a great deal of care as their illness progresses, and the number of affected individuals is increasing dramatically as a result of the aging population. Current estimates suggest that there are approximately 24 million patients with Alzheimer’s disease worldwide, but a threefold increase in this number is expected by the year 2050. Such an increase in the number of individuals needing extended care will certainly strain our health care system; notably, strategies such as using improved diagnostic tools to detect the disease in its initial stages, and developing novel treatments to slow the course of the disease, would both do much to bolster the ability of health care systems worldwide to deal with this critical population.
 
Psychiatric diseases are sometimes referred to as ‘the chronic diseases of the young.’ They occur more often than is generally assumed; in addition, these illnesses—or facets of these illnesses—are already present during adolescence, meaning that they occur before an individual’s ‘productive’ years. Many treatments exist for the most disabling psychiatric disorders; however, these are far from ideal. Many patients do not respond to any available medications; furthermore, their side effects often pose significant problems. Finally, even when patients do respond to medications, there can often be a significant lag between receiving the medication and seeing significant effects, leaving patients vulnerable. Better treatments—that is, treatments that are more effective for more patients, that act faster, and that have fewer side effects—are urgently needed to treat psychiatric disorders.
 
With regard to the final area of focus— pain—there is a large arsenal of available painkillers. Nevertheless, these are associated with considerable side effects, and new, more easily tolerated painkillers are needed.
 
Growth by focusing
Given the fact that our resources are limited and the field is large, it would, of course,  be impossible to tackle the entire domain of neuroscience.  For this reason, we focus on certain sub-areas that meet certain criteria: first, that the area of focus is characterized by a number of major, unmet medical needs; second, that some scientific progress has already been made; and third, that we have the required expertise to address the research questions. Such expertise is located both ‘in-house’—within our own department and in other therapeutic domains—as well as externally, through partnerships with other pharmaceutical or biotech companies, members of academia, and public authorities.
 
Within the neurodegenerative disorders, we focus primarily on Alzheimer’s disease. For psychiatric diseases, we specialize in schizophrenia, bipolar disorder, and treatment-resistant major depressive disorder. In the area of pain relief, we concentrate on chronic forms of pain. We sometimes opt not to become involved in the complete process from research and development up to, and including, commercialization. With regard to pain, for example, the research phase is carried out by external parties.
 
Integrated solutions are the future
The various diseases that fall under the general heading of “neuroscience” are often so complex that more than one medicine is needed to achieve optimum patient care, both in the short- and long-term. We therefore strongly believe in the added value of integrated solutions that support the patient from the moment of diagnosis up to and including aftercare. In concrete terms, this refers to biomarkers to detect the subtype of the disorder as early as possible after diagnosis. Another key focus is finding the right medication, ideally one that is both effective, devoid of debilitating side effects, and user-friendly. We are also working on developing measuring devices and ‘intelligent’ forms of administration that the patient can monitor and handle from a distance, or those that encourage therapy compliance. Finally, we also study services that could support aftercare, or nursing care. The Integrated Solutions Group of Neurosciences is ready for the challenge of developing integrated solutions for the individual patient. It is also important to note that any such strategies are tested in trial studies; we are, of course, only satisfied if a patient’s situation really improves as a result.
 
The growing success of biologics
Another trend in the field of neuroscience is the growing success of biologics. In this area, we hope to reach targets that could not be targeted with small molecules. Toward that end, we work closely with J&J’s Biotechnology Center of Excellence. We also continue to search for biomarkers to detect Alzheimer’s disease in its initial stage, that is, before the brain becomes (substantially) damaged. This is particularly important because by the time many patients are diagnosed with Alzheimer’s disease, they may have been living with the disease for 20 to 30 years.
 
Exchange of data and cooperation
Understanding these complex disorders requires a great deal of data. We exchange these data with patient associations, companies, and public authorities. This takes place via The Coalition Against Major Diseases and The Innovative Medicines Initiative, among others. We also continue to collect data from patients as early as Phase 1 clinical studies. In this area, as in so many others, the key to success is cooperation. It is important that this cooperation occurs, especially between internal and external parties for the exchange of knowledge and data, and for the translation of research from the laboratory to the clinic.
 
We strongly believe in the future of our neuroscience-related research. Our ultimate target is to offer integrated solutions to patients with major unmet medical needs. The fact that we can really make a difference for our patients is a wonderful thought that continues to motivate us.
Husseini K. Manji