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Rheumatologists Continue to Increase Their Use of Biologics for the Treatment of RA

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Compared to a year ago, the use of biologics continues to increase, especially in those patients with severe RA. However, one-third of patients across the severity scale are still not achieving an optimal response with biologics, indicating both an unmet need and an opportunity.

Rheumatologists discontinue the use of a biologic for a variety of reasons, and a couple of the top reasons are safety / tolerability concerns and insufficient efficacy. When a patient is switched from one biologic to another, the main reasons are poor response and efficacy plateauing. Insurance issues and the cost to the patient are also important factors in both discontinuation and switching decisions.

In the next six months, the use of those biologic agents with a unique mechanism of action (MOA) is expected to increase. These products include Bristol-Myers Squibb’s Orencia SC, and Genentech/Roche’s Rituxan and Actemra. The share increase for these three products will most likely be at the expense of Amgen/Pfizer’s Enbrel and Abbott Labs’ Humira, the current market leaders. Until this change happens, both Enbrel and Humira continue to be used interchangeably between first-line and second-line.

Awareness was relatively high among surveyed rheumatologists with respect to new compounds in late-stage development for RA. Interest was highest for Pfizer’s tofacitinib, an oral JAK inhibitor currently under FDA review. The most desired attributes for any new RA therapy are long-term safety and sustained efficacy.

TreatmentTrends®: Rheumatoid Arthritis is a syndicated quarterly report series that examines current trends in the management of RA from the perspective of rheumatologists with a focus on analyzing their attitudes, perceptions, and self-reported prescribing behavior. In addition, this report provides insight into practice patterns, and current and projected use of various products. TreatmentTrends also evaluates perceived product advantages and disadvantages, as well as sales and messaging efforts of key market players. The Q1 2012 wave was fielded with 102 rheumatologists in the U.S. in late February 2012 via an on-line survey. A parallel annual report covering the European market (EU5) will be available in November 2012.