Use of biologic/JAK monotherapy is primarily driven by adequate patient response on monotherapy, tolerability issues with traditional DMARDs, or comorbidities preventing use, according to recent findings from Spherix Global Insights
EXTON, Pa., October 23, 2017 /PRNewswire/ — Despite rheumatologists (n=102) reports of increased monotherapy over the past year, most feel that methotrexate (MTX) is still the backbone of rheumatoid arthritis (RA) treatment. Additionally, study respondents are largely in agreement that RA patients who take biologics/JAKs in combination with traditional disease-modifying antirheumatic drugs (tDMARDs) have a better clinical response than those on monotherapy. With newer brands, such as Kevzara and Xeljanz touting monotherapy efficacy, rheumatologists’ willingness to prescribe these brands without MTX or other tDMARDs is key.
Clinical trials for Kevzara involved a head to head comparison of Kevzara monotherapy (200mg) versus monotherapy with AbbVie’s Humira (40mg), which demonstrated superiority of the IL-6 inhibitor with regard to reduced disease activity, improved physical function, and a greater proportion of patients achieving remission over 24 weeks. However, brand loyalty to the long withstanding subcutaneous TNF inhibitors appears to have more weight in brand selection, even when a monotherapy regimen is desired. Indeed, when asked what brand is most often chosen when they want to prescribe biologic/JAK monotherapy, over half of the sampled physicians selected Amgen’s Enbrel or Humira. Regardless of stated brand preference for monotherapy, actual rates of treatment without tDMARDs are highest for Xeljanz, Kevzara, and Actemra, results consistent with a companion patient audit study recently published by Spherix, involving over 1,000 RA patients recently switched from one biologic or Xeljanz to another brand.
Kevzara has been on the market since late May and has seen a steady increase in trial rates since launch, with one-quarter of rheumatologists reporting use of the newest IL-6 inhibitor in Q3. Additionally, four out of five respondents report recent contact with a Sanofi/Regeneron representative, and trial rates among those who have seen a Sanofi/Regeneron sales representative are significantly higher than those who have not been detailed. According to the respondents, most Kevzara sales representative messages focused on a review of clinical trials or patient support programs, and one-third noted that Kevzara’s efficacy as a monotherapy was a topic of discussion. Another third of rheumatologists who have been detailed report positioning of Kevzara in place of Actemra, the other IL-6 inhibitor approved for RA. This could be the ultimate challenge for Kevzara, as Actemra has long-standing post marketing experience, flexible dosing options with IV and subcutaneous formulations, and overall rheumatologists note that they are struggling to find the benefit of Kevzara over Actemra.
RealTime Dynamix™: Rheumatoid Arthritis, is an independent report series published on a quarterly basis. The series tracks the evolution of the RA market, provides a deep dive on launch effectiveness, and highlights opportunities for pipeline agents. The next wave of research will be fielded in November 2017.
About Spherix Global Insights
Spherix Global Insights is a market intelligence agency, 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.
All company, brand or product names in this document are trademarks of their respective holders.
To view media coverage of this release, click here.