Janssen's Stelara and Novartis' Cosentyx Take the Cake When Psoriasis Patients Switch between Biologic/Otezla Agents, According To a Recent Audit of Nearly 1,000 Recently Switched Psoriasis Patients Conducted by Spherix Global Insights
Over one in five psoriasis patients are reported to switch between biologics or Celgene's Otezla to a different brand within a given year
EXTON, Pa., Oct. 31, 2017 /PRNewswire/ -- Spherix Global Insights announces the release of RealWorld Dynamix™: Biologic and Otezla Switching in Psoriasis, a project undertaken in collaboration with 201 US dermatologists who provided detailed chart reviews for nearly 1,000 psoriasis (PsO) patients recently switched from one biologic or Otezla to another brand.
US dermatologists estimate that more than 20% of their biologic or Otezla treated PsO patients switch to a different brand within a given year, with the majority of switching occurring between first and second-lines of therapy. Though TNF-inhibitors, namely AbbVie's Humira and Amgen's Enbrel, dominate the first-line PsO setting, the patient audit reveals that alternate mechanism of action (MOA) biologics are the big winners when switching occurs. Cosentyx, Stelara, and Eli Lilly's Taltz all enjoy substantial gains in market share with each subsequent line of therapy. Indeed, when asked about their preference for a non-TNF in psoriasis, the group is almost equally divided between those preferring Stelara versus an IL-17. Conversely, Humira, Enbrel, and Otezla, each with a strong foothold as first-line agents, suffer the greatest overall net losses when PsO switching occurs. Humira and Otezla maintain a competitive position in the second-line setting as well; however, if patients are not treated with Enbrel in the first-line setting they are unlikely to ever be exposed to the brand.
In comparison to a parallel audit of patients with psoriatic arthritis (PsA), RealWorld Dynamix™: Biologic and Otezla Switching in Psoriatic Arthritis, dermatologists are much more open and likely to move to agents with alternate MOAs in the second-line treatment setting compared to rheumatologists who manage PsA patients. In fact, the practice of TNF-cycling, or switching between TNF-inhibiting biologics, accounted for over 40% of all recent switches amongst PsA patients, whereas only one-tenth of all recent PsO switches involved switching between TNF-inhibitors.
The most common reasons for switching off a biologic or Otezla are related to a lack of efficacy, with primary failures (lack of initial response) accounting for more than double the switches as secondary failures (waning efficacy). The most cited reason behind selection of the "switch-to" agent is the desire for a specific MOA, while just over one-in-five are primarily attributed to patient requests, which disproportionately favor the oral agent Otezla.
Analysis of first-line regimens of recently switched patients reveals that Otezla has made some strides as a "pre-biologic" therapy, with rates of first-line use significantly greater amongst patients initiated more recently compared to those initiated over two years ago. However, with the ever expanding psoriasis armamentarium of highly efficacious biologics, these gains may prove to be too little, too late. Though dermatologists agree that they like the convenience and safety of Celgene's PDE4 inhibitor, less than half of the respondents agree that the small molecule is a generally efficacious option for PsO.
Overall, dermatologists report that only two-thirds of their biologic-treated patients and less than half of their Otezla-treated patients are considered "well-managed," leaving plenty of room for challengers to drive switches among patients not achieving optimal results. Though general dermatologist familiarity with the PsO pipeline is low, it is only a matter of time before the next generation of biologics is introduced, with agents such as UCB's bimekizumab, Sun Pharma/Merck's tildrakizumab, and AbbVie's risankizumab, which boasts clinical trial efficacy unrivaled by any existing approved agents.
RealWorld Dynamix™: Biologic and JAK Switching in Psoriasis (US) is a robust and deep patient chart analysis of 950 PsO patients who were switched from one biologic or Otezla to a different brand in the past three months. RealWorld Dynamix™ captures the clinician's perspective on why the switch was made and the new brand chosen, as well as future intentions should the response be suboptimal. In addition to patient demographics and treatment history, clinical assessments, diagnostic tests and laboratory values are included to provide insight into the clinical course of the disease.
About Spherix Global Insights Spherix Global Insights is an independent 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.
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