PsA, a disease characterized by flaky psoriatic skin lesions, erosive joint damage, and complicating comorbidities, remains poorly understood, underdiagnosed, and undertreated. Nevertheless, TNF inhibitors have revolutionized treatment of the disease and expanded the PsA therapy market to a multibillion-dollar entity. In recent years, several novel therapies with alternative MOAs, such as the IL-12/23 inhibitor ustekinumab, the oral PDE4 inhibitor apremilast, and the IL-17A inhibitor secukinumab, have entered this market and notably improved the outcome of patients who have an inadequate response to TNF inhibitors.
Three biologics and three oral agents are in late-phase development for PsA and are expected to launch during the 2018-2028 study period. Thought-leading physicians describe a dynamic patient-management environment with a growing need for additional novel therapies. In this content, we analyze physician perception and anticipated positioning of these agents and the implications for the market-leading TNF inhibitor class.