Cosentyx Plateaus as Non-TNF Agents Prepare to Dominate in Psoriatic Arthritis

Although there are a growing number of rheumatologists in the United States who report the use of Cosentyx to treat psoriatic arthritis (PsA), the increasing user base has failed to translate into overall increases in biologic share, according to market research company Spherix Global Insights.
The plateau of Cosentyx is partially fueled by pipeline PsA agents, which offer patients more options for non-TNF treatments, including Orcenia, Xeljanz, and Taltz, according to a press release.
The findings, which are from the most recent quarterly update of Spherix’s RealTime Dynamix Psoriatic Arthritis, also indicated that in quarter 2 of 2016, rheumatologists anticipated doubling their Cosentyx share over the subsequent 6-month period, a projection that panned out and was fully realized in practice, according to the release.
Since the end of 2016, however, rheumatologists have continued to forecast positive Cosentyx growth, but failed to see those projections through.
Most rheumatologists indicate patients who have previously failed at least 1 TNF agent are considered the most ideal for Cosentyx treatment.
Although this is a population that represents nearly half of all PsA patients treated with biologics, the cause of the plateau may derive from the low percentage of rheumatologists who indicate satisfaction with this medication, Spherix stated.
According to the data, just under one-third of rheumatologists reported high satisfaction with the IL-17 inhibitor, a percentage that is significantly lower compared with leading TNF agents and Stelara.
They also prefer Humira over Cosentyx for patients with severe psoriasis, even though Cosentyx is associated with strong efficacy in skin clearance. Furthermore, Cosentyx use is continuously hampered by rheumatologists’ perceptions of inferior market access compared with established biologic products, according to the release.
Nearly one-third of respondents believe Cosentyx’s first-to-market status is a significant advantage over Taltz, but there has been a significant increase in Taltz familiarity over the past year and a growing number of rheumatologists anticipate routine use of Taltz after it receives approval.
“Taltz is expected to have a competitive position in the PsA treatment paradigm if available, however most rheumatologists agree that there is a higher unmet need for new, oral, small molecule agents for PsA than for any additional alternate MOA biologics,” the release stated. “Indeed, when asked directly which agent they would most like to see gain the PsA indication, 61% selected a JAK inhibitor, such as Pfizer’s Xeljanz, whereas the remaining respondents were split between BMS’ Orencia, and additional IL-17 such as Taltz, and an IL-23 inhibitor.”
In the RealWorld Dynamix: Biologic and Otezla Switching in PsA, more than 1000 patients with PsA who recently switched from 1 biologic or Otezla to a different brand were evaluated. The findings showed Xeljanz represented 2% of the switch population and 1 of 5 recently switched patients are considered good candidates for future Xeljanz treatment.

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