Less Than One Year Post Launch, AbbVie's Rinvoq Disrupts the Rheumatoid Arthritis Treatment Landscape, While a Rich Pipeline Waits in the Wings
Approved in 2012, Xeljanz enjoyed the "only JAK inhibitor" status for six years until Eli Lilly's Olumiant was approved.
EXTON, Pa., June 4, 2020 /PRNewswire/ -- The latest quarterly report included in Spherix's RealTime Dynamix: Rheumatoid Arthritis (US) service captures the responses of 105 rheumatologists surveyed in May 2020 and highlights the shifting dynamics of the rheumatoid arthritis (RA) treatment landscape, driven largely by the recent approval of AbbVie's JAK inhibitor, Rinvoq, as well as the present impact of the COVID-19 pandemic on rheumatology practices. According to the survey results that are trended back to 2016, the RA treatment landscape continues to shift away from the legacy TNF inhibitors (i.e., AbbVie's Humira and Amgen's Enbrel) which have long been the gold standard, while alternate mechanism of action (MOA) agents have remained relatively stable in both user base and brand share – with the exception of the newest market entrant, Rinvoq.
Perhaps the greatest impact of Rinvoq is being felt by Pfizer's Xeljanz. Approved in 2012, Xeljanz enjoyed the "only JAK inhibitor" status for six years until Eli Lilly's Olumiant was approved. Where Olumiant faced challenges with regulatory delays and ultimately a less than desirable product label, Rinvoq came out of the gates strong. In only nine months on the market, the majority of rheumatologists now select Rinvoq as their JAK of choice if limited to just one for the treatment of RA. Indeed, rheumatologists report that more than one in five of their JAK-treated RA patients are currently prescribed Rinvoq, and six-month projections call for this figure to double. AbbVie's SELECT-COMPARE trial, demonstrating Rinvoq's superiority over Humira, appears to be giving Rinvoq an advantage over existing JAK inhibitors, Xeljanz and Olumiant.
While the clinical data for Rinvoq is strong, the "AbbVie Effect" is also in full force; rheumatologists (in addition to dermatologists and gastroenterologists) consistently rate AbbVie as the strongest industry partner. AbbVie representatives are in active promotion mode, with current reports of virtual detailing during the COVID-19 crisis, often providing samples which are helping to generate new patient starts and to bridge patients through the prior authorization process. In addition, rheumatologists report the recently debuted direct to consumer marketing campaign is driving increased patient requests for the brand, a majority of which result in a prescription.
Though rheumatologists seem to favor Rinvoq of late, they are also likely to prescribe a second and even a third JAK agent if the first JAK fails, a behavior that mimics the traditional treatment pattern of TNF-cycling. In fact, JAK-cycling has increased significantly versus a year ago, with the availability of the third option (Rinvoq) now available. Despite increased use of the class, rheumatologists remain unsure as to which JAK pathway they believe to be the most efficacious and the safest treatment of RA, despite messaging efforts by manufacturers to attempt differentiation on this front.
Rinvoq may soon have to share the spotlight with another JAK, Gilead's filgotinib, which has the greatest unaided and aided awareness of all pipeline assets tested. Filgotinib, the next likely agent to launch in RA, is also selected by almost one-half of surveyed rheumatologists as the "favorite" agent among pipeline assets and is the only agent respondents predict will have a presence in the first-line setting soon after launch. Positive perceptions surrounding Gilead's pipeline agent are perhaps (at least somewhat) a byproduct of the increased positive publicity the company has received associated with the approval of remdesivir as a COVID-19 treatment. Filgotinib also stands the possibility of bringing to the table an improved safety profile over existing JAKs, but the degree to which this positively impacts FDA labeling is yet to be seen.
Other agents with novel MOAs, including EMD Serono's BTK inhibitor, evobrutinib and GSK's anti-granulocyte macrophage colony-stimulating factor (anti GM-CSF) monoclonal antibody, otilimab, are also generating early positive mentions. Indeed, this rich pipeline is poised to continue transforming the advanced systemic treatment landscape over the coming years.
About RealTime Dynamix™
RealTime Dynamix™: Rheumatoid Arthritis (US) is an independent service providing strategic guidance through rapid and comprehensive quarterly reports, which include market trending since 2016, launch tracking, and a fresh infusion of unique content with each wave.
About Spherix Global Insights
Spherix Global Insights is a hyper-focused market intelligence firm that leverages our own independent data and expertise to provide strategic guidance, so biopharma stakeholders make decisions with confidence. We specialize in select immunology, nephrology, and neurology markets.
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