So what is neurogenic OH or neurogenic orthostatic hypotension? I think many of you in the room might be familiar with orthostatic hypertension, again a drop in blood pressure when going quickly from supine or bending over to standing up, some of us may have even experience this occasionally, but neurogenic orthostatic hypotension is really a result of depleted norepinephrine levels, and Northera treats the root cause of that neurogenic OH and these patients are really pretty severely impacted by this disease, I mean unlike us maybe after some dehydration or naiad out have that fleeting dizziness. These people can’t stand for more than a couple of minutes a few times a day, many of them, so it’s really debilitating, it’s impactful on their quality of life and with dizziness and lightheadedness comes falls and really major events. So we are pretty proud to be offering these people an opportunity to improve their lives.
Now the Neurogenic OH patient comes from clattery of underlying neurological diseases I have a few listed here. Neurogenic OH is orphan at less than 200,000 patients in the U.S. and clearly the largest population that makes up the disease pay for us is Parkinson's disease.
The therapeutic options for Neurogenic OH are limited there is only one approved drug for this indication and that’s mitogen and it’s been on the market for some time now and it was approved based on accelerated pathway and demonstrating improvements in blood pressures is a surrogate marker for symptoms. The drug was never able to show an impact on symptoms even though that was a post approval commitment the company is still trying to do that.
Combined with that inability to show impact on symptoms, the drug is a very potent base of constrictor and increases blood pressure quite dramatically and these patients with neurological disease is not only of hypotension or low blood pressure upon standing, they also experience hypertension or high blood pressure when they’re lying down, so a very potent base of constricted that is indiscriminate is really not the ideal therapy for these patients.
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