DecisionBase PDFs

March 2010

Psoriasis: Dermatologists Identify Remaining Opportunities as the Number of Highly Efficacious Biologics Continues to Grow

Introduction:

Three highly efficacious biologics are competing for leadership in the psoriasis market: the historical and 2009 sales leader, etanercept (Amgen/Pfizer/Takeda’s Enbrel); the most recently approved TNF-α inhibitor, adalimumab (Abbott/Eisai’s Humira); and the first interleukin (IL) inhibitor launched for psoriasis, ustekinumab (Centocor Ortho Biotech/Janssen-Cilag’s Stelara). The anticipated market entry of a second IL inhibitor, Abbott’s briakinumab, in early 2011 will further expand treatment options and challenge the dominance of the TNF-α inhibitors as first-line biologics. Although each of the marketed biologics offers significant improvements in efficacy and/or dosing over its predecessors, important opportunities remain for new agents that demonstrate safety benefits with long-term administration.

Questions Answered in This Report:

  *   A drug’s ability to induce PASI 75 response at 12 weeks has been the standard efficacy end point assessed in late-phase trials for psoriasis, but it is not commonly used in medical practice. How do U.S. and European dermatologists weight specific efficacy end points and other drug attributes in their prescribing decisions for psoriasis? What are the key primary and secondary clinical trial end points evaluated in ongoing trials of new therapies seeking regulatory approval for psoriasis?

  *   Etanercept is the 2008 major-market sales leader for psoriasis. How will etanercept and other current therapies fare against emerging therapies? Will emerging therapies offer improvements in the efficacy end points and drug attributes that are most influential in physician prescribing decisions? If so, which drugs will suffer the most from entry of these new agents?

  *   Based on its clinical profile, ustekinumab is the 2009 clinical gold standard in our Drug Comparator Model. What attributes do thought leaders believe differentiate this drug from competing current and emerging therapies? Will any drugs in development challenge ustekinumab as the gold standard for 2013 or 2018?

Scope:

Key drug development opportunity tested in our target product profiles for psoriasis: A biological agent that carries a lower theoretical risk of malignancies than biologics currently marketed for the treatment of psoriasis.

Physicians surveyed for this study: 60 U.S. and 30 European dermatologists.

Comprehensive List of Therapies Included in Our Research and Modeling

Current Therapies

- Etanercept (Amgen/Pfizer/Takeda’s Enbrel)

- Adalimumab (Abbott/Eisai’s Humira)

- Infliximab (Centocor Ortho Biotech/Merck/Mitsubishi Tanabe’s Remicade)

- Methotrexate (Dava’s Rheumatrex, generics)

- Ustekinumab (Centocor Ortho Biotech/Janssen-Cilag’s Stelara)

Emerging Therapies

- Briakinumab (Abbott)

- Apremilast (Celgene)

- Voclosporin (Isotechnika Pharma)

- AIN-457 (Novartis)

- Fezakinumab (Pfizer)

Search Reports

Mentioned in this report:

  • Companies:
  • - Abbott
  • - Allergan
  • - Amgen
  • - Astellas
  • - Biogen Idec
  • - Cambridge Antibody Technology
  • - Celgene
  • - Cellgate
  • - Centocor Ortho Biotech
  • - CollaGenex
  • - Dava
  • - Eisai
  • - Eli Lilly
  • - Galderma
  • - Genentech
  • - GlaxoSmithKline
  • - Incyte
  • - Isotechnika Pharma
  • - Janssen-Cilag (division of Johnson & Johnson)
  • - Knoll
  • - Leo
  • - Lux Biosciences
  • - Maruho
  • - Merck Serono (division of Merck KGaA)
  • - Mitsubishi Tanabe
  • - Novartis
  • - Paladin
  • - Pfizer
  • - Roche
  • - Takeda
  • - UCB
  • - Warner Chilcott