Market Outlook

Chronic spontaneous urticaria (CSU), also known as chronic idiopathic urticaria, presents as hives that persist daily or almost daily for six weeks or longer without an obvious known stimulus. Drug treatment is largely dominated by anti-histamines. However, one biologic, Novartis/Roche’s Xolair, is approved for chronic idiopathic urticaria, which clinical guidelines recommend as a third-line treatment. Xolair’s dominance demonstrates that opportunity remains in the CSU market for other biologics in development. In addition, montelukast is a key drug in the CSU market and a preferred combination agent, consistent with the recommended use of leukotriene receptor antagonists as add-on treatment in the current urticaria treatment guidelines.

Questions Answered

  • What patient share do key therapies and brands garner by line of therapy in newly diagnosed CSU patients? What are the quarterly trends in prescribing among recently treated and newly diagnosed CSU patients?
  • How has Xolair been integrated into the treatment algorithm? Do the TNF-alpha inhibitors see any off-label use for CSU?
  • What proportion of CSU patients receive drug therapy within one year of diagnosis, and how quickly? What percentage of patients progress to later lines of therapy within one year of diagnosis?
  • What percentage of CSU patients are treated with monotherapy versus combination therapy? What are the most widely used combination therapies?
  • What are the product-level compliance and persistency rates among drug-treated patients with CSU?

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