The increasingly crowded RA market boasts many targeted agents representing several different drug classes, including blockbuster TNF-α inhibitors, five non-TNF-α biologics (including the second IL-6 inhibitor Kevzara [Regeneron / Sanofi]), and five oral JAK inhibitors—Xeljanz (Pfizer), Olumiant (Eli Lilly), Rinvoq (AbbVie), Jyseleca (Galapagos / Gilead / Eisai), and Smyraf (Astellas). The TNF-α inhibitors are the most widely prescribed biologics for RA that is refractory to conventional DMARDs, and the non-TNF-α biologics and JAK inhibitors largely compete for use in the TNF-refractory population. With the recent approval of an additional JAK inhibitor (Gilead / Galapagos’s Jyseleca) and biosimilars of several TNF and non-TNF biologics, marketers are facing fierce competition and increasing challenges to gain market share.

Questions answered:

  • What are physicians’ preferred TNF-α inhibitors, and what factors are influencing this perception? Given the increasingly fragmented RA market, how likely are physicians to cycle through multiple anti-TNF agents before progressing to a novel MOA?
  • What are physicians’ perceptions of the currently marketed non-TNF-α inhibitor biologics and oral JAK inhibitors, and where do these agents fit in their current treatment approach? Which of these agents has been/will be the most successful in targeting the TNF-refractory patient segment?
  • How will the entry of additional novel oral therapies affect the RA treatment algorithm, and in which patient segments and lines of treatment will these therapies most likely be used? How will the entry of biosimilars affect the market sales and patient share of currently marketed RA agents and the entry of emerging therapies?

Scope:

Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, and Japan.

Primary research: 27 country-specific interviews with thought leaders.

Epidemiology: Number of total, diagnosed, and drug-treated prevalent cases of RA; number of diagnosed prevalent cases of RA by severity.

Emerging therapies: Preregistered / registered: 1 drug; Phase III: 2 drugs; coverage of 8 select early-phase pipeline products.

Table of contents

  • Rheumatoid Arthritis - Landscape & Forecast - Disease Landscape & Forecast
    • Key Updates
      • Q1 2021
        • March 2021
        • February 2021
        • January 2021
      • Q4 2020
        • December 2020
        • November 2020
        • October 2020
      • Q3 2020
        • September 2020
      • Q2 2020
        • June 2020
    • Key Findings
      • Rheumatoid Arthritis - Key Findings - March 2021
        • June 2020
    • Market Outlook
      • Key Findings
        • Market Share of Drug Classes for Rheumatoid Arthritis: 2019
        • Market Share of Drug Classes for Rheumatoid Arthritis: 2029
        • Rheumatoid Arthritis SWOT Analysis
      • COVID-19: Areas of Potential Forecast Impact
        • Market Drivers and Constraints
          • What Factors Are Driving the Market for Rheumatoid Arthritis?
          • What Factors Are Constraining the Market for Rheumatoid Arthritis?
          • Major-Market Sales by Drug Class in Rheumatoid Arthritis: 2019-2029
          • Major-Market Patient Shares of Biologics and JAK Inhibitors in Rheumatoid Arthritis: 2019-2029
        • Drug-Class-Specific Trends
          • Major-Market Sales of TNF-Alpha Inhibitors for Rheumatoid Arthritis: 2019-2029
          • Major-Market Brand and Biosimilar Patient Share for TNF-Alpha Inhibitors in Rheumatoid Arthritis: 2019-2029
          • Major-Market Patient Share of Abatacept SC, IV, and Molecule Total for Rheumatoid Arthritis: 2019-2029
          • Major-Market Brand and Biosimilar Patient Share and Total Sales for Rituximab in Rheumatoid Arthritis: 2019-2029
          • Major-Market Sales and Patient Share of IL-6 Inhibitors for Rheumatoid Arthritis: 2019-2029
          • Major-Market Patient Share of JAK Inhibitors for Rheumatoid Arthritis: 2019-2029
          • Major-Market Sales of JAK Inhibitors for Rheumatoid Arthritis: 2019-2029
          • Major-Market Sales and Patient Share of Otilimab for Rheumatoid Arthritis: 2019-2029
          • Major-Market Sales of Recently Approved and Emerging Agents for Rheumatoid Arthritis: 2019-2029
      • Forecast
        • Market Forecast Assumptions
        • Market Forecast Dashboard
      • Etiology and Pathophysiology
        • Disease Overview
          • Etiology
            • Genetic Factors
            • Environmental Risk Factors
          • Pathophysiology
            • Disease Progression
            • Disease Progression in Rheumatoid Arthritis
            • Pathological Changes in the Joints of Patients with Rheumatoid Arthritis
            • Adaptive and Innate Immune Responses in Disease Pathogenesis
          • Key Pathways and Drug Targets
            • Select Drug Targets in Rheumatoid Arthritis
            • Select Cytokines Involved in the Pathogenesis of Rheumatoid Arthritis
            • Other Inflammatory Mediators Involved in the Pathogenesis of Rheumatoid Arthritis
        • Epidemiology
          • Key Findings
            • Epidemiology Populations
              • Disease Definition
              • Methods
              • Sources Used for Total Prevalent Cases of Rheumatoid Arthritis
              • Number of Total, Diagnosed, and Drug-Treated Prevalent Cases of Rheumatoid Arthritis in the Major Pharmaceutical Markets: 2019-2029 (thousands)
              • Number of Diagnosed Prevalent Cases of Rheumatoid Arthritis in the Major Pharmaceutical Markets: 2019-2029 (thousands)
              • Disease Definition
              • Methods
              • Sources Used for Diagnosed Prevalent Cases by Severity in Rheumatoid Arthritis
              • Number of Diagnosed Prevalent Cases of Rheumatoid Arthritis in the Major Pharmaceutical Markets by Severity: 2019-2029 (thousands)
              • Number of Drug-Treated Prevalent Cases of Rheumatoid Arthritis in the Major Pharmaceutical Markets: 2019-2029 (thousands)
          • Current Treatment
            • Key Findings
              • Treatment Goals
                • Key Endpoints Used in Clinical Trials for Rheumatoid Arthritis
              • Key Current Therapies
                • Overview
                • Mechanism of Action of Key Current Drug Classes Used for Rheumatoid Arthritis
                • Current Treatments Used for Rheumatoid Arthritis
                • Market Events Impacting the Use of Key Current Therapies in Rheumatoid Arthritis
                • Advantages and Disadvantages of Etanercept
                • Advantages and Disadvantages of Infliximab
                • Expert Insight: Infliximab
                • Advantages and Disadvantages of Adalimumab
                • Advantages and Disadvantages of Simponi
                • Expert Insight: Simponi
                • Advantages and Disadvantages of Cimzia
                • Expert Insight: Cimzia
                • Advantages and Disadvantages of Orencia
                • Expert Insight: Orencia
                • Advantages and Disadvantages of Rituximab
                • Expert Insight: Rituximab
                • Advantages and Disadvantages of Actemra / RoActemra
                • Expert Insight: Actemra / RoActemra
                • Advantages and Disadvantages of Kevzara
                • Expert Insight: Kevzara
                • Advantages and Disadvantages of Xeljanz
                • Expert Insight: Xeljanz
                • Advantages and Disadvantages of Olumiant
                • Expert Insight: Olumiant
                • Advantages and Disadvantages of Rinvoq
                • Expert Insight: Rinvoq
                • Advantages and Disadvantages of Jyseleca
                • Expert Insight: Jyseleca
                • Smyraf
                • Advantages and Disadvantages of Smyraf
                • Expert Insight: Smyraf
                • Advantages and Disadvantages of Pralia
                • Expert Insight: Use of Pralia in the Treatment of Rheumatoid Arthritis
              • Medical Practice
                • Overview
                • Country-Specific Rheumatoid Arthritis Treatment Guidelines
                • Factors Influencing Drug Selection in Rheumatoid Arthritis
                • Treatment Decision Tree for Rheumatoid Arthritis: United States
                • Treatment Decision Tree for Rheumatoid Arthritis: Europe
                • Treatment Decision Tree for Rheumatoid Arthritis: Japan
            • Unmet Need Overview
              • Current and Future Attainment of Unmet Needs in Rheumatoid Arthritis
              • Top Unmet Needs in Rheumatoid Arthritis: Current and Future Attainment
            • Emerging Therapies
              • Key Findings
                • Pipeline Trends for Rheumatoid Arthritis
              • Key Emerging Therapies
                • Estimated Launch Dates of Key Emerging Therapies for the Treatment of Rheumatoid Arthritis
                • Olokizumab Profile
                • Analysis of the Clinical Development Program for Olokizumab
                • Expert Insight: Olokizumab
                • Expectations for Launch and Sales Opportunity of Olokizumab in Rheumatoid Arthritis
                • Likely Uses of Olokizumab for the Treatment of Rheumatoid Arthritis
                • Otilimab Profile
                • Key Ongoing Clinical Trials of Otilimab in the Treatment of Rheumatoid Arthritis
                • Analysis of the Clinical Development Program for Otilimab
                • Expert Insight: Otilimab
                • Expectations for Launch and Sales Opportunity of Otilimab in Rheumatoid Arthritis
                • Likely Uses of Otilimab for the Treatment of Rheumatoid Arthritis
              • Early-Phase Pipeline Analysis
                • Select Compounds in Early-Phase Development for Rheumatoid Arthritis
              • Key Discontinuations and Failures in Rheumatoid Arthritis
                • Key Discontinuations and Failures
            • Access & Reimbursement Overview
              • Region-Specific Reimbursement Practices
                • Key Market Access Considerations in Rheumatoid Arthritis: United States
                • General Reimbursement Environment: United States
                • Key Market Access Considerations in Rheumatoid Arthritis: EU5
                • General Reimbursement Environment: EU5
                • Key Market Access Considerations in Rheumatoid Arthritis: Japan
                • General Reimbursement Environment: Japan
            • Appendix
              • Key Abbreviations Related to Rheumatoid Arthritis
              • Brands, Marketers, and Generic Availability of Current Therapies Used for Rheumatoid Arthritis by Market
              • Rheumatoid Arthritis Bibliography

          Author(s): Colleen E. Albacker, Ph.D.; Aishwarya S. Ambat

          Colleen Albacker, Ph.D., is a senior director on the Immune and Inflammatory Disorders team at DRG, part of Clarivate. She manages a team of analysts generating syndicated market research content on respiratory, rheumatology, and dermatology indications. She has authored market research reports analyzing physician, payer, and market trends in such respiratory indications as asthma and COPD. Dr. Albacker earned her doctorate from Harvard University and her bachelor’s degree from Pennsylvania State University.

          Aishwarya S. Ambat, M.P.H., is an associate epidemiologist at DRG, part of Clarivate. She received her M.P.H. from the Manipal Academy of Higher Education in India and holds a bachelor’s degree in physiotherapy.


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