Analysis of Over 1000 Psoriatic Arthritis (PsA) Patients Reveals Large Candidate Pool for Pfizer's Xeljanz, BMS' Orencia, and Eli Lilly's Taltz
EXTON, Pa., Sept. 26, 2017 /PRNewswire/ -- According to a new sub-analysis of PsA patients recently switched from one biologic or Otezla to another brand (n=1,008), US rheumatologists foresee a sizable proportion of PsA patients on second or later lines of therapy as candidates for treatment with agents in development or with the recently approved Orencia. Specifically, over one-quarter of recently switched PsA patients are either currently treated off-label with Xeljanz, will be switched to Xeljanz next if their current agent is unsuccessful, or are considered good candidates for Pfizer's JAK. One in five fit the same bill for treatment with the IL-17 inhibitor, Taltz, while around 15% of patients were recently switched to, are likely to be switched to, or are considered good candidates for treatment with Orencia.
Patients switched to Celgene's Otezla were frequently switched as a result of a patient request, significantly more commonly than those switched to a biologic agent. Xeljanz is expected to challenge Otezla for patients wanting an oral option but not achieving optimal results with Otezla. Not only is Xeljanz attractive as an additional oral option, it is also seen as a great treatment for prior biologic failures; as PsA patients progress through the treatment algorithm onto later lines of therapy, Xeljanz candidacy skyrockets. Furthermore, despite recent associations between JAK inhibitors and various cardiovascular (CV) issues, such as deep vein thrombosis and pulmonary embolism, there is no significant difference in the CV risk profile of PsA patients considered good candidates for future treatment with Xeljanz compared to non-candidates; potentially implying that CV risk is not a large deterrent for future Xeljanz prescribing in PsA.
Growth in the switching share of alternative MOAs was primarily driven by increased use of Cosentyx, Novartis' IL-17 inhibitor. Immediately prior to being approved for PsA, Cosentyx captured 1% of the switch share, this year the brand's switching share jumped to 11%. While most of the patients originated from TNF inhibitors, the true impact was felt most by Stelara, Janssen's IL-12/23 inhibitor. In terms of pipeline threats, a high percentage of PsA patients recently switched to Cosentyx are also considered good candidates for Eli Lilly's Taltz, another IL-17 currently approved for psoriasis. Furthermore, if the treating rheumatologist is unhappy with their Cosentyx patients' response at their next visit, nearly 40% will be switched again, leaving ample opportunity for use of Taltz, if approved for PsA.
Of those considered good candidates for treatment with Orencia, just over half were candidates for both the intravenous and subcutaneous forms of administration, while the remaining were contenders for treatment with just one administration form. In an early analysis of a companion study in rheumatoid arthritis (RA), where Orencia is fully integrated into the treatment algorithm, BMS' T-cell co-stimulation modulator captures about ten percent of the recently switched RA population. Rheumatologists' experience with Orencia for the treatment of RA may indeed bolster use of the agent in PsA, now that it is approved.
RealWorld Dynamix(TM): Biologic/Otezla Switching in PsA (US) is a robust and deep patient chart analysis of 1,008 PsA patients who were switched from one biologic or Otezla to a different brand in Q1 2017. RealWorld Dynamix(TM) captures the clinician's perspective on why the switch was made and the new brand chosen, as well as future intentions should the response be suboptimal. In addition to patient demographics and treatment history, clinical assessments, diagnostic tests and laboratory values are included to provide insight into the clinical course of the disease.
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