IL-17s stop Janssen’s Stelara in its tracks and while Cosentyx holds out as the only approved IL-17 in PsA, competition is looming – according to a recent study by Spherix Global Insights
CAMBRIDGE, Mass., April 4, 2017 /PRNewswire/ — Spherix Global Insights has just released the results of two independent surveys of 200 rheumatologists and dermatologists about the evolving practice patterns in the management of psoriasis (PsO) and psoriatic arthritis (PsA). The surveys were fielded in March.
In both studies, specialists report that the use of IL-17 agents, such as Novartis’ Cosentyx and Lilly’s Taltz is increasing. In the psoriasis market, where both drugs are approved, Taltz is making big gains and is expected to catch up to Cosentyx within the next two quarters. Overall, a slightly higher percentage of dermatologists would choose Cosentyx over Taltz if they were limited to just one IL-17 drug, but as Taltz continues to penetrate the PsO market, a preference battle is likely to emerge. An interesting finding in the psoriasis study is the impact of the IL-17 class on Stelara – among those planning to increase their use of IL-17s, more than a third predict corresponding decreases in Janssen’s IL-12/23 inhibitor.
Studies estimate that up to 30% of patients with psoriasis will have an arthritic component to their disease and for these patients, the co-management between rheumatologists and dermatologists can add a layer of complexity. Less than one in five of the surveyed rheumatologists agree that dermatologists refer these patients at the first sign of joint involvement; far more agree that they first attempt to manage PsA and only refer if joint pain is not controlled. For now, Cosentyx has the advantage of a dual indication, but Taltz is likely to snag a PsA indication soon, placing the two on an even playing field.
While much of the focus has been on the IL-17 class, the solid first line position of AbbVie’s Humira in both PsA and PsO cannot be overlooked. Not only is Humira deeply entrenched, but AbbVie is selected by the highest percent of both rheumatologists and dermatologists as the manufacturer offering the best support and Humira is the biologic most frequently requested by patients. Overall, however, patient requests are most frequently related to preference for an oral agent. Having an oral formulation is one of the most desirable characteristics in new products and is the leading advantage for Celgene’s Otezla which continues to gain share in more mild-to-moderate disease. While 17% of the rheumatologists do report off-label experience with Pfizer’s Xeljanz in PsA, the lack of an indication for psoriasis may limit this oral JAK inhibitor from gaining widespread use as the majority of rheumatologists prefer to use agents with a dual PsA/PsO indication.
Moving forward, it looks as though dermatology is becoming the new rheumatology. With increased comfort prescribing biologics and a plethora of new agents to choose from, it is no surprise that more than 80% of the surveyed dermatologists report that their use of biologics has increased in the past year. Added to this, the recent approval of Sanofi-Regeneron’s Dupixent for atopic dermatitis expands the biologics into other key dermatology indications.
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About Spherix Global Insights
Spherix Global Insights is a 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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