Ankylosing Spondylitis (AS) - Market Insights, Epidemiology, and Market Forecast - 2032

This ‘Ankylosing Spondylitis (AS)-Market Insights, Epidemiology, and Market Forecast-2032' report deliver an in-depth understanding of the AS, historical and forecasted epidemiology as well as the AS market trends in the United States, , EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan.

The Ankylosing Spondylitis market report provides current treatment practices, emerging drugs, and market share of the individual therapies, current and forecasted 7MM market size from 2019 to 2032. The Report also covers current AS treatment practice, market drivers, market barriers, SWOT analysis, reimbursement and market access, and unmet medical needs to curate the best of the opportunities and assesses the underlying potential of the market.

Geography Covered

• The United States
• EU5 (Germany, France, Italy, Spain, and the United Kingdom)
• Japan

Study Period: 2019-2032

Ankylosing Spondylitis (AS) Disease Understanding and Treatment Algorithm

Ankylosing Spondylitis (AS) Overview

Ankylosing Spondylitis (AS) also called as Bechterew's disease is a common inflammatory rheumatic disease that affects the axial skeleton, causing characteristic inflammatory back pain, which can lead to structural and functional impairments and a decrease in quality of life. Clinical features of this group include inflammatory back pain, asymmetrical peripheral oligoarthritis (predominantly of the lower limbs), enthesitis, and specific organ involvement such as anterior uveitis, psoriasis, and chronic inflammatory bowel disease. Aortic root involvement and conduction abnormalities are rare complications of AS. AS affects men more often than women.

General onset of AS commonly occurs in younger people, between the ages of 17 and 45. However, it can also affect children and those who are much older (Spondylitis association of america).AS is a type of spondyloarthropathy (SpA) - Spondyloarthropathies are a family of related inflammatory rheumatic disorders which also include reactive arthritis (RA), psoriatic arthritis (PsA), spondyloarthropathy associated with inflammatory bowel disease (IBD), undifferentiated spondyloarthropathy (USpA), and, possibly, Whipple disease and Behçet disease - and is often found in association with other spondyloarthropathies, including ReA, PsA, ulcerative colitis (UC), and Crohn disease. It has also been found that such patients quite often have a family history of either AS or another spondyloarthropathy.

Ankylosing Spondylitis (AS) Diagnosis

The most commonly used criteria for the classification of AS were developed in 1966 and modified in 1984. They are:

1. Low back pain of at least three months duration with inflammatory characteristics (improved by exercise, not relieved by rest)
2. Limitation of lumbar spine motion in sagittal and frontal planes
3. Decreased chest expansion (relative to normal values for age and sex)
4. Bilateral sacroiliitis grade 2 or higher
5. Unilateral sacroiliitis grade 3 or higher.

Definite AS is said to be present when the fourth or fifth criterion presents with any clinical criteria. However, radiological sacroiliitis may not develop for many years, and the development of new criteria (including magnetic resonance imaging) has been proposed to allow confirmation of the diagnosis in patients with early disease.

Ankylosing Spondylitis (AS) Treatment

Treatment of Ankylosing spondylitis will depend on the symptoms, age, and general health. It will also depend on how severe the condition is. The treatment goal is to reduce pain and stiffness, prevent deformities, and maintain as normal lifestyle as possible. Treatment may include: Nonsteroidal anti-inflammatory medications to reduce pain and inflammation, tumor-necrosis-factor blockers (biologic medications) to reduce inflammation and swelling, disease-modifying antirheumatic drugs (DMARDs) such as sulfasalazine to decrease inflammation and control AS, short-term use of corticosteroids to reduce inflammation, short-term use of muscle relaxants and pain relievers to relieve severe pain and muscle spasms, surgery to replace a joint, place rods in the spine, or remove parts of the thickened and hardened bone. Moreover, maintaining proper posture and regular exercise, including exercises that strengthen back muscles, is vital (Johns Hopkins Medicine, n.d.).

Ankylosing Spondylitis (AS) Epidemiology

The disease epidemiology covered in the report provides historical as well as forecasted epidemiology segmented by Total Prevalent cases of Ankylosing Spondylitis, Diagnosed Prevalent cases of Ankylosing Spondylitis, Gender-specific Diagnosed Prevalent cases of Ankylosing Spondylitis, Age-specific Diagnosed Prevalent cases of Ankylosing Spondylitis, and Gene-specific Diagnosed Prevalent cases of Ankylosing Spondylitis scenario in the 7MM countries from 2019 to 2032.

Key Findings

• Total prevalent population of AS in seven major markets is 2,282,664 in 2021. These cases are estimated to increase in the forecast period
• As per the estimates there were nearly 968,326 AS cases in EU-5 countries in 2021. Germany accounted for the highest number of cases in 2021, followed by Spain and United Kingdom.
• Among EU5 countries, Italy had the highest number of diagnosed prevalent cases for AS (191,566 cases), while UK had the least cases (54,634) in 2021.
• Total diagnosed prevalent cases of Ankylosing Spondylitis in Japan was found to be 4,095 in the year 2021.
• Total diagnosed prevalent cases of Ankylosing Spondylitis in Japan was found to be 4,095 in the year 2021.

Ankylosing Spondylitis (AS) Epidemiology

The epidemiology segment also provides the AS epidemiology data and findings across the 7MM (US, EU5, Japan).

Ankylosing Spondylitis (AS) Drug Chapters

Ankylosing Spondylitis (AS) Emerging Drugs

Bimekizumab: UCB Biopharma

Bimekizumab (UCB4940) is the first humanized monoclonal IgG1 antibody that potently and selectively neutralizes IL-17A and IL-17F. These two key proinflammatory cytokines share similar biological functions and structural homology. IL-17A and IL-17F are the most closely related members of the IL-17 family of cytokines. They are both co-expressed at sites of inflammation and have overlapping proinflammatory functions. Both IL-17A and IL-17F can independently cooperate with other inflammatory mediators to drive chronic inflammation and tissue destruction. This therapeutic candidate is in the Phase III stage of development to treat patients with ankylosing spondylitis (AS). The company is using the subcutaneous route of administration for AS.

CC-99677: Celgene

CC-99677 is a novel, oral, selective mk2 inhibitor with sustainable multi-cytokine inhibitor for the treatment of AS and other inflammatory diseases. The mitogen-activated protein kinase-activated protein kinase-2 (MK2) pathway is activated downstream of p38, and activation of MK2 increases the stability and translation of mRNA of proinflammatory factors (e.g., TNF-α, IL-17, IL-6). Inhibitors of p38 are associated with tachyphylaxis in patients with RA and other inflammatory diseases, where early reduction in ex vivo production of cytokines, such as TNF-α, or endogenous inflammatory markers, such as CRP, did not persist despite continued treatment. Thus, p38 inhibitors have not advanced in clinical development. Targets downstream of p38 have been identified to avoid these limitations.

Ankylosing Spondylitis (AS) Market Outlook

Ankylosing spondylitis (AS) is an inflammatory disease that, over time, can cause some of the small bones in the spine (vertebrae) to fuse. This fusing makes the spine less flexible and can result in a hunched-forward posture. If ribs are affected, it can be difficult to breathe deeply. There is no cure for AS, but treatments can lessen your symptoms and possibly slow progression of the disease. Recent studies show that the newer biologic medications can potentially slow disease progression in some people. Different people respond to different medications with varying levels of effectiveness. Thus, it may take time to find the most effective course of treatment.

A common treatment regimen for the various forms of spondyloarthritis (AS, psoriatic arthritis, enteropathic arthritis, reactive arthritis, juvenile spondyloarthritis, and undifferentiated spondyloarthritis) involves medication, exercise, physical therapy, good posture practices, and other options such as applying heat/cold to help relax muscles and reduce joint pain. In severe cases, posture correcting surgery may also be an option.

Depending on the type of spondyloarthritis, there may be some variation in treatment. For example, in psoriatic arthritis, both the skin component and joint component must be treated. In enteropathic arthritis (spondylitis/arthritis associated with inflammatory bowel disease), medications may need to be adjusted so the gastrointestinal component of the disease is also treated and not exacerbated.

As per the study conducted by Ward et al., (2019), recommendations for AS and nonradiographic axial SpA are similar. TNFi are recommended over secukinumab or ixekizumab as the first biologic to be used. Secukinumab or ixekizumab is recommended over the use of a second TNFi in patients with primary nonresponse to the first TNFi. TNFi, secukinumab, and ixekizumab are favored over tofacitinib. Co‐administration of low‐dose methotrexate with TNFi is not recommended, nor is a strict treat‐to‐target strategy or discontinuation or tapering of biologics in patients with stable disease. Sulfasalazine is recommended only for persistent peripheral arthritis when TNFi are contraindicated.

Of the patients included in the study, 40.6% persisted on the index TNFi for ≥12 months, 31.0% discontinued, 21.4% switched to a different TNFi, and 7.0% discontinued and then restarted. Of the 333 patients who persisted on their TNFi for >90 days, 44.7% received ≥1 add-on medication. Approximately half of the patients (45.1%) initiated etanercept, followed by adalimumab (28.6%), golimumab (11.7%), infliximab (11.7%), and certolizumab pegol (2.8%) as their index TNFi was stated in a study conducted by Walsh et al., (2018).

Key Findings

• The market size of Ankylosing Spondylitis (AS) in the 7MM was USD 4,200 million in 2021.
• In 2021, the market size of AS in the US was 3,224 which is the highest among the 7MM countries.
• The total current market of AS is calculated based on the characterization of the current market into three segments: conventional therapies, biologics, and Cox Inhibitors. It has been estimated that majority of the patients are recommended the use of biologics, as compared to other class drugs.
• From various clinical studies it has been observed that AS involves medication, exercise, physical therapy, good posture practices, and other options such as applying heat/cold to help relax muscles and reduce joint pain. In severe cases, posture correcting surgery may also be an option.

The United States Market Outlook

This section provides the total AS market size and market size by therapies & class in the United States.

EU-5 Market Outlook

The total AS market size and market size by therapies in Germany, France, Italy, Spain, and the United Kingdom are provided in this section.

Japan Market Outlook

The total AS market size and market size by therapies in Japan are provided.

Ankylosing Spondylitis (AS) Drugs Uptake

This section focuses on the rate of uptake of the potential drugs recently launched in the AS market or expected to get launched in the market during the study period 2019-2032. The analysis covers the AS market uptake by drugs; patient uptake by therapies; and sales of each drug.

This helps in understanding the drugs with the most rapid uptake, reasons behind the maximal use of new drugs, and allows the comparison of the drugs based on market share and size which again will be useful in investigating factors important in market uptake and in making financial and regulatory decisions.

Ankylosing Spondylitis (AS) Development Activities

The report provides insights into different therapeutic candidates in phase II, and phase III stage. It also analyzes key players involved in developing targeted therapeutics.

Pipeline Development Activities

The report covers the detailed information of collaborations, acquisition, and merger, licensing, and patent details for AS emerging therapies.

Reimbursement Scenario in Ankylosing Spondylitis (AS)

Approaching reimbursement proactively can have a positive impact both during the late stages of product development and well after product launch. In the report, we consider reimbursement to identify economically attractive indications and market opportunities. When working with finite resources, the ability to select the markets with the fewest reimbursement barriers can be a critical business and price strategy.

Competitive Intelligence Analysis

The publisher performs competitive and market Intelligence analysis of the AS market by using various competitive intelligence tools that include-SWOT analysis, PESTLE analysis, Porter's five forces, BCG Matrix, Market entry strategies, etc. The inclusion of the analysis entirely depends upon the data availability.

Scope of the Report

• The report covers the descriptive overview of AS, explaining its causes, symptoms, pathophysiology, genetic basis, and currently available therapies.
• Comprehensive insight has been provided into the AS epidemiology and treatment.
• Additionally, an all-inclusive account of both the current and emerging therapies for AS is provided, along with the assessment of new therapies, which will have an impact on the current treatment landscape.
• A detailed review of the AS market; historical and forecasted is included in the report, covering the United States drug outreach.
• The report provides an edge while developing business strategies, by understanding trends shaping and driving the United States AS market.

Report Highlights

• The robust pipeline with novel MOA and oral ROA, increasing incidence, effectiveness of drugs as both mono and combination therapy will positively drive the AS market.
• The companies and academics are working to assess challenges and seek opportunities that could influence AS R&D. The therapies under development are focused on novel approaches to treat/improve the disease condition.
• Major players are involved in developing therapies for AS. The launch of emerging therapies will significantly impact the AS market.
• Our in-depth analysis of the pipeline assets across different stages of development (phase III and phase II), different emerging trends and comparative analysis of pipeline products with detailed clinical profiles, key cross-competition, launch date along with product development activities will support the clients in the decision-making process regarding their therapeutic portfolio by identifying the overall scenario of the research and development activities.

Ankylosing Spondylitis (AS) Report Insights

• Patient Population
• Therapeutic Approaches
• AS Pipeline Analysis
• AS Market Size and Trends
• Market Opportunities
• Impact of upcoming Therapies

Ankylosing Spondylitis (AS)Report Key Strengths

• 11 Years Forecast
• 7MM Coverage
• AS Epidemiology Segmentation
• Key Cross Competition
• Highly Analyzed Market
• Drugs Uptake

Ankylosing Spondylitis (AS) Report Assessment

• Current Treatment Practices
• Unmet Needs
• Pipeline Product Profiles
• Market Attractiveness
• Market Drivers and Barriers
• SWOT analysis

Key Questions Answered

Market Insights:

• What was the AS market share (%) distribution in 2019 and how it would look like in 2032?
• What would be the AS total market size as well as market size by therapies across the United States during the forecast period (2022-2032)?
• What are the key findings pertaining to the market across the United States and which country will have the largest AS market size during the forecast period (2022-2032)?
• At what CAGR, the AS market is expected to grow at the United States level during the forecast period (2022-2032)?
• What would be the AS market outlook across the United States during the forecast period (2022-2032)?
• What would be the AS market growth till 2030 and what will be the resultant market size in the year 2032?
• How would the market drivers, barriers, and future opportunities affect the market dynamics and subsequent analysis of the associated trends?

Epidemiology Insights:

• What are the disease risk, burdens, and unmet needs of AS?
• What is the historical AS patient pool in the 7MM countries?
• What would be the forecasted patient pool of AS at the 7MM level?
• What will be the growth opportunities across the 7MM countries with respect to the patient population pertaining to AS?
• At what CAGR the population is expected to grow across the 7MM countries during the forecast period (2022-2032)?

Current Treatment Scenario, Marketed Drugs, and Emerging Therapies:

• What are the current options for the treatment of AS along with the approved therapy?
• What are the current treatment guidelines for the treatment of AS in the 7MM countries?
• What are the AS marketed drugs and their MOA, regulatory milestones, product development activities, advantages, disadvantages, safety, and efficacy, etc.?
• How many companies are developing therapies for the treatment of AS?
• How many emerging therapies are in the mid-stage and late stages of development for the treatment of AS?
• What are the key collaborations (Industry-Industry, Industry-Academia), Mergers and acquisitions, licensing activities related to the AS therapies?
• What are the recent novel therapies, targets, mechanisms of action, and technologies developed to overcome the limitation of existing therapies?
• What are the clinical studies going on for AS and their status?
• What are the key designations that have been granted for the emerging therapies for AS?
• What are the 7MM historical and forecasted market of AS?

Reasons to Buy

• The report will help in developing business strategies by understanding trends shaping and driving AS.
• To understand the future market competition in the AS market and Insightful review of the key market drivers and barriers.
• Organize sales and marketing efforts by identifying the best opportunities for AS in the 7MM countries.
• Identification of strong upcoming players in the market will help in devising strategies that will help in getting ahead of competitors.
• Organize sales and marketing efforts by identifying the best opportunities for the AS market.
• To understand the future market competition in the AS market.