Spherix Global Insights

June 28, 2018

Bolstered Skin Clearance Allows for Ample First-Line Use of Biologics with Alternate Mechanisms of Action for the Treatment of Psoriasis

Data from over 1,000 psoriasis patients initiated on biologic or small molecule therapy for the first time reveals agents with alternate mechanisms of action–Janssen’s Stelara and Tremfya, Novartis’ Cosentyx, Eli Lilly’s Taltz, and Celgene’s Otezla, account for more than two-thirds of all recent first-line psoriasis initiations.

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EXTON, Pa., June 28, 2018 /PRNewswire/ – The US dermatology market has undergone rapid change over the past several years, with the introduction of six new biologics in psoriasis alone—five of which are biologics with alternate mechanisms of action (MOA). These new market entrants are known for their strong efficacy in skin clearance, and have had recent success leapfrogging TNF-inhibitors as first-line biologic/small molecule options.

In April 2018, Spherix Global Insights collaborated with 154 US dermatologists to analyze the records of 1,010 psoriasis patients recently initiated on their biologic or Otezla therapy for the first time. When queried about their recent changes in psoriasis patient management, one-quarter of the treating dermatologists noted that they are using the “newer” biologics with alternate mechanisms of action more frequently and earlier in the psoriasis treatment algorithm. Indeed, when isolating audited new start patients to just those on biologics (excluding Otezla), agents with alternate MOAs accounted for over half of the recent initiations.

Despite recent strides in market access and being the only oral advanced therapy option for the treatment of psoriasis, Otezla captured less than 30% of the pre-biologic market among audited patients. When patients were treated with Otezla prior to biologics, the oral administration was a major driving factor; with that, patient requests were also common drivers behind pre-biologic use.

Overall, one-fifth of all recent first-line brand selections were primarily driven by the agent’s efficacy in skin clearance, a figure that was significantly higher for Tremfya and the IL-17 inhibitors than for other brands. Other drivers behind brand selection that had varying degrees of influence on specific brands included insurance mandates, desire for a specific MOA, safety profile, efficacy in both skin and joints, comfort, and patient requests.

Treating dermatologists also reported that they plan to wait approximately sixteen weeks to assess patient success and revealed their likely next choice, should the first-line agent be unsuccessful. Analysis of the next likely course of treatment suggested that next generation alternate MOA biologics will further expand. In both first-line and switch patients, the sun may be setting on the use of TNF inhibitors for the treatment of psoriasis—an aspect particularly worrisome for UCB’s Cimzia, which only recently gained approval for psoriasis, making it the fourth TNF-inhibitor FDA approved for the disease. Furthermore, when physicians were asked if patients were candidates for treatment with pipeline agents (Cimzia, Sun Pharma’s tildrakizumab (Ilumya), AbbVie’s risankizumab, and UCB’s bimekizumab), candidacy for treatment with Cimzia was much less prominent than for the other pipeline agents with alternate MOAs.

RealWorld Dynamix: Biologic and Small Molecule New Starts in Psoriasis integrates physician survey responses with in-depth audits of over 1,000 patients with psoriasis who were recently initiated on their first-line biologic or Otezla. Variables captured in the audit include time since diagnosis and referral, physician/patient discussion on initiating biologic therapy and the timeliness of occurrence, presentation at first referral and initiation of first-line agent (including key laboratory measures, BSA, location and severity affected by psoriasis, presence of psoriatic arthritis), patient co-morbidities, concomitant medications, health-related quality of life metrics, rationale for brand selection, back-up brand choice, next step in the treatment paradigm, and candidacy for select pipeline agents. For a full list of the variables collected or to learn more about the RealWorld Dynamix offering, please contact us to speak with an expert.

About Spherix Global Insights
Spherix Global Insights is an independent business intelligence and market research company, specializing in renal, autoimmune, neurologic and rare disease markets. Our aim is to apply our commercial experience and unique relationships within core specialty markets to translate data into insight, enabling our clients to make smarter business decisions.

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Lynn Price, Immunology Franchise Head
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