The Vast Galaxy of Neurology

Words by Michaila Byrne

Neurology is a complex therapy area that requires a high level of expertise and sensitivity, making it a unique and challenging area for medical affairs professionals. How do these challenges shape the MA role in this space and how is the landscape evolving currently?

As the command centre of the central nervous system, the brain stands as the most complex organ in the human body, containing more nerve cells than there are stars in the Milky Way. Consequently, neurological conditions are relatively uncharted territory and encompass a host of diseases spanning multiple sclerosis to cerebral palsy. Presently, electroencephalography and MRI machines are the closest tools we have available for detection.

So, with the approval by the FDA of the first Alzheimer’s drug and increased understanding of the use of cannabinoids in epilepsy treatment, what challenges shape the unique role for medical affairs in neurology and where will the next foray of exploration into the brain lead the industry next?

Recent advancements in conditions like spinal muscular atrophy, among other central nervous system disorders, demonstrate how innovative and progressive the neurology space is in the 21st century. As Kayhan Binazir, Global Scientific Communications Director, Roche, points out: “MA has a privileged position to deliver on those opportunities and scientific advances in order to preserve what makes people who they are…Neurology in MA is different from the other therapy areas in that the return of neuroscience and neurology (it was absent for a while) is now coming back at a time of unimaginable medical advances and diagnostics.” The potential in this space is limitless and brimming with the potential to transform healthcare narratives from no treatment options to producing multiple life-changing therapies.

Neurology in MA is different from the other therapy areas

While this potential is titillating, launching into the unknown presents its own unique set of challenges, some of which are accompanied by cognitive decline for the patient. Alla Zozulya Weidenfeller, Medical Director, Head of Medical Affairs Neurology, Europe, Middle East and Africa, Lupin, recommends a holistic approach: “Often it is a lack of evidence-based knowledge, unawareness of treatment options, poor understanding of the complexity of the disease, and impact of mental health in some neurological indications…The lack of properly installed clinical outcome measures for the patients underestimates the burden of disease on their quality of life.” The complex physical presentation of neurological conditions, both visible and invisible, can complicate matters even further. Lori Lebson, Head, US Medical Affairs, Neurology and Immunology, EMD Serono. Inc, elaborates: “Another unique challenge that can arise when communicating the needs of people living with neurological disorders is that patients can present with diverse symptoms ranging from physical, cognitive, and behavioural.”

Like many skin conditions and sexually transmitted diseases, neurological conditions are often the most misunderstood and carry a lot of unfounded fear and stigma. Binazir goes as far as to suggest sociological factors have a part to play here: “Every disease needs bespoke communications training. Layering on top the cultural differences, language, religion, and socioeconomic [factors], you see how challenging it can be to give a diagnosis and then manage and work with the patient and the family.” To address these challenges, Binazir advocates for improved understanding to underpin care and communication: “Overall, I would like to see people be more accepting of people with neurological diseases, working with them to ensure their voice and contribution to society is felt.”

But the future is bright for the neurology space; despite the unique challenge of the multi-faceted, heterogeneous manifestations and often multi-systemic nature of these diseases, they are suited for the future of personalised care. “Many neurological conditions need an individual, personalised approach to stratify optimally the treatments available... Treatment stratification is very important to ensure that patients can benefit in the best possible way from disease-modifying and effective symptomatic treatments,” explains Weidenfeller, adding: “As MA is at the interface of interactions between pharma and healthcare professionals, they should work to address needs, facilitate evidence-based decisions, and put in place meaningful clinical studies for the patients.”

Neurological conditions need an individual, personalised approach to stratify optimally the treatments available

With so much more to discover about neurological conditions, the galaxy of the nervous system is ripe for exploration. Fortunately, the evolution of MA is suited to the natural progression of technology and healthcare we are bearing witness to and, as Lebson puts it: “The scientific innovations for understanding neurological diseases are paving the way for better, more personalised approaches to care. With greater understanding of the disease, novel approaches to therapy, and the use of technology to better serve patient populations, the next decade brings great hope and promise to the field of neurology.”