Rheumatoid Arthritis (Event Driven)
Decision Resources, Inc, December 2011, Pages: 173
The rheumatoid arthritis (RA) therapy market has matured to the point that TNF-a inhibitors are firmly established as first-line biological agents. Biological drugs in other drug classes—the interleukin-6 (IL-6) inhibitor tocilizumab (Roche/Chugai's Actemra/RoActemra), the selective costimulation modulator abatacept (Bristol-Myers Squibb/Ono Pharmaceutical's Orencia), and the B-cell-targeted therapy rituximab (Biogen Idec/Roche/Chugai/Zenyaku Kogyo's Rituxan, Roche's MabThera)—underscore the dominance of the TNF-a inhibitors because these new agents are reserved for patients who fail to achieve an adequate response to TNF-a inhibitor therapy. For emerging agents, the remaining opportunity is limited and the barrier to entry is high in the absence of clear advantages and improvements over marketed therapies.
Executive Summary
What are the key parameters of the RA market?
What factors are driving the market for RA therapies?
What factors are constraining the market for RA therapies?
What are the drug development activities of note in RA?
What do the experts say?
What key challenges and opportunities remain?
1 Etiology and Pathophysiology
Overview
Etiology
Genetic Influences in Rheumatoid Arthritis
Environmental Risk Factors
Hormonal Risk Factors
Pathophysiology
Disease Course and Staging
Classification Systems
The Roles of Innate and Adaptive Immune Responses in Disease Pathogenesis
Phagocytic Cells
Natural Killer (NK) Cells
T Cells
B Cells
Important Inflammatory Mediators
Cytokines
Chemokines
Nuclear Factor ?
B Kinases
Costimulatory Molecules
Integrins
Toll-Like Receptors
Mediators of Structural Damage
Matrix Metalloproteinases
Receptor Activator of Nuclear Factor ?B Ligand
Extra-Articular and Systemic Manifestations
Prognosis
2 Epidemiology and Patient Populations
Overview
Disease Definition
Methods
Subpopulations
Diagnosed and Drug-Treated Populations
Percentage Diagnosed
Percentage Drug-Treated
Immune and Inflammatory Disorders
3 Current Therapies and Medical Practice
Treatment Providers
Rheumatoid Arthritis
Goals of Treatment
Currently Marketed Products
Treatment Guidelines and Factors Influencing Drug Selection
Treatment Algorithm
Country-Specific Prescribing Practices
Country-Specific Reimbursement Issues
4 Unmet Needs
Overview
Therapies with Greater Disease-Modifying Ability
Therapies and Treatment Strategies that Induce Remission in a Greater Percentage of Patients
Oral Therapies with Efficacy Comparable to That of Biological Agents
Predictors of Treatment Response to Biologics
5 Emerging Therapies
Overview
Future Positioning of Key Competitors
Early-Stage Therapies
Janus-Activated Kinase Inhibitors
Overview
Mechanism of Action
Tofacitinib (formerly known as tasocitinib or CP-690550)
Syk Inhibitors
Overview
Mechanism of Action
Fostamatinib Disodium
Interleukin-6 Inhibitors
Overview
Mechanism of Action
Sarilumab
ALD-518
Conventional Disease-Modifying Antirheumatic Drugs
6 Market Outlook
Overview
Drug-Class-Specific Trends
Tumor Necrosis Factor-Alpha Inhibitors
Selective Costimulation Modulators
B-Cell-Targeted Therapies
Interleukin-6 Inhibitors
Interleukin-1 Inhibitors
Novel Oral Agents
Conventional DMARDs
Immune and Inflammatory Disorders
Appendix A Bibliography—Rheumatoid Arthritis
Appendix B Market Forecast Methodology
Rheumatoid Arthritis
Bottom-Up Market Forecasting Overview
Patient Populations
Drug-Specific Assumptions
General Sources of Data
Agents Included in Our Market Analysis
Pricing, Dosing, Days of Therapy, and Compliance Assumptions
General Statements About Pricing
Dosing, Days of Therapy and Compliance
Tumor Necrosis Factor-Alpha Inhibitors
Selective Costimulation Modulators
B-Cell-Targeted Therapies
Interleukin-6 Inhibitors
Interleukin-1 Inhibitors
Conventional DMARDs
Generic Erosion
Etanercept
Infliximab
Adalimumab
Abatacept
Tocilizumab
Rituximab
Leflunomide
Cyclosporine
Tacrolimus
Emerging Therapy Prices
Golimumab
Certolizumab Pegol
Tofacitinib (formerly known as tasocitinib or CP-690550)
Fostamatinib Disodium (R-788)
Sarilumab
ALD-518
Iguratimod
Appendix C Experts Interviewed—Rheumatoid Arthritis
Appendix D Supplemental Epidemiology Bibliography
Immune and Inflammatory Disorders
Tables and Figures
Rheumatoid Arthritis
Table 1-1 Select Cytokines Involved in the Pathogenesis of Rheumatoid Arthritis
Table 2-1 Number of Total, Diagnosed, and Drug-Treated Prevalent Cases of Rheumatoid Arthritis in the Major Pharmaceutical Markets, 2010-2020 (thousands)
Table 2-2 Number of Diagnosed Prevalent Cases of Rheumatoid Arthritis in the Major Pharmaceutical Markets by Severity, 2010-2020
Table 2-3 Key Sources for Epidemiology Estimates—Rheumatoid Arthritis
Table 3-1 Rheumatoid Arthritis Treatment Providers and Referral Patterns, by Market
Table 3-2 Clinical Trial End Points Used for Approval of Therapies for the Treatment of Rheumatoid Arthritis
Table 3-3 Current Therapies Used for Rheumatoid Arthritis
Table 3-4 Current Classes Used for Rheumatoid Arthritis—Mechanism of Action
Table 3-5 Comparison of Agents Commonly Used for Rheumatoid Arthritis
Table 3-6 Comparison of Biological Therapies in Reducing Signs and Symptoms of Rheumatoid Arthritis, Assessed at Two Years
Table 3-7 Comparison of Biologics and Methotrexate in Reducing Signs and Symptoms of Rheumatoid Arthritis, Assessed at Six Months and One Year
Table 3-8 Comparison of Ability of Select Rheumatoid Arthritis Therapies to Induce Remission
Table 3-9 Comparison of Clinical Efficacy of Select Rheumatoid Arthritis Therapies in Slowing or Halting Progression of Structural Damage
Table 3-10 Comparison of Clinical Efficacy of Select Rheumatoid Arthritis Therapies in Inducing a Major Clinical Response
Table 3-11 Comparison of Clinical Efficacy of Select Rheumatoid Arthritis Therapies in Improving Physical Function
Table 3-12 Expert Commentary: Leading Drugs in Rheumatoid Arthritis
Table 3-13 Rheumatoid Arthritis Treatment Guidelines, by Market
Table 3-14 Factors Influencing Drug Selection in Rheumatoid Arthritis
Table 3-15 Summary of the 1987 American College of Rheumatology Criteria for the Diagnosis of Rheumatoid Arthritis
Table 3-16 2010 American College of Rheumatology-European League Against Rheumatism Classification Criteria
Table 3-17 Clinical Trials of Biologics Conducted in Patients with Early Rheumatoid Arthritis
Table 3-18 Most Commonly Prescribed Therapies for Rheumatoid Arthritis
Table 3-19 Expert Rheumatologists' Insight on Prescribing Trends, by Market
Immune and Inflammatory Disorders
Table 3-20 Reimbursement Environment in Rheumatoid Arthritis, by Market
Table 5-1 Therapies in Late-Stage Development for Rheumatoid Arthritis
Table 5-2 Estimated Launch Dates for Key Emerging Therapies for the Treatment of Rheumatoid Arthritis
Table 5-3 Select Agents in Early-Stage Development for Rheumatoid Arthritis
Table 5-4 Phase II Trials for Tofacitinib (CP-690550)
Table 5-5 Pivotal Phase III Trials for Tofacitinib (CP-690550)
Table 6-1 Sales of Drugs to Treat Rheumatoid Arthritis (all populations) in the Major Pharmaceutical Markets, 2010-2020
Table 6-2 Timeline of Key Market Events for Rheumatoid Arthritis
Table B-1 Sources for Drug Prices
Figure 1-1 Pathological Changes in the Joints of Patients with Rheumatoid Arthritis
Figure 1-2 Select Drug Targets in Rheumatoid Arthritis
Figure 1-3 Disease Progression in Rheumatoid Arthritis
Figure 2-1 Prevalence and Total Prevalent Cases of Rheumatoid Arthritis in the Major Pharmaceutical Markets, 2010
Figure 3-1 Current Treatment Algorithm for Rheumatoid Arthritis
Figure 4-1 Unmet Needs: Attainment and Remaining Opportunity in Rheumatoid Arthritis
Figure 6-1 Rheumatoid Arthritis Therapies, 2010-2020: Market Share
Figure 6-2 Timeline of Near-Term Events in Rheumatoid Arthritis
Customers who bought this item also bought
All rights reserved. © Copyright 2013 Research and Markets WWW5
Terms and Conditions Privacy Policy Publishers Employment Opportunities Site Map Link to us Webmaster Affiliate Network
