BMS’ Orencia Plunges into the Fray of Battle for Alternative MOA for Psoriatic Arthritis with Recent FDA Approval…. Can it Find a Unique Space to Play?

Approval of Orencia for Psoriatic Arthritis (PsA) opens door for expansion of use based on existing off-label experience, adding further challenge to Novartis’s Cosentyx and Janssen’s Stelara for preferred TNF alternative, according to recent reports from Spherix Global Insights.

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EXTON, Pa., July 6, 2017 /PRNewswire/ — BMS’ Orencia, already indicated for Rheumatoid Arthritis, gained FDA approval for use in patients with Psoriatic Arthritis (PsA). In RealTime Dynamix™: Psoriatic Arthritis Q1, 2017, Spherix Global Insights found that nearly half of the surveyed rheumatologists desired new, alternative MOAs, and over one-third wanted agents with proven efficacy in patients who have failed anti-TNF treatment. In clinical trials, Orencia demonstrated significant improvement over placebo in both patients that were prior anti-TNF failures and TNF-naïve PsA patients. Additionally, Orencia’s unique MOA as a selective T-cell co-stimulation modulator, will position the latest market entrant to meet these stated needs from prescribers. In fact, a significant number of rheumatologists surveyed in this study already have experience using Orencia for PsA patients off-label.

Orencia enters a competitive market, where the battle for anti-TNF alternatives is currently raging between Janssen’s Stelara and Novartis’ Cosentyx, as detailed in the recently published RealWorld Dynamix™: Biologic Switching in PsA. This annual patient chart audit gathered data from over 1,000 PsA patients recently switched between biologic brands and/or Celgene’s Otezla. The independent publication highlights the jockeying between Cosentyx and Stelara for share of recently switched patients, the majority of whom had failed at least one anti-TNF agent. Add to the picture a pipeline of agents from the IL-17 class (Lilly’s Taltz) and oral JAK inhibitors (Pfizer’s Xeljanz, AbbVie’s upadacitinib) and the future market begins to look very crowded. However, Orencia will have an additional hurdle to overcome due to the lack of an indication for psoriasis, something that many rheumatologists claim is important when selecting a biologic for PsA. In terms of where rheumatologists will use Orencia, the picture from RealTime Dynamix™: PsA Q1 2017 is mixed, suggesting that Orencia can draw from both alternative mechanism biologics and may also challenge the established anti-TNFs, adding further disruption to the pattern of anti-TNF cycling. Two strengths BMS can leverage include the existing loyal user base of rheumatologists, already highly familiar and satisfied with Orencia in RA, as well as the flexibility of dual SC/IV administration options.

The upcoming RealTime Dynamix™: Psoriatic Arthritis Q3, 2017 will contain a deep dive on the impact of the entry of Orencia into the PsA market.

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About Spherix Global Insights
Spherix Global Insights is a business intelligence and market research company, specializing in renal, autoimmune, neurologic and rare disease markets. Our aim is to apply our commercial experience and unique relationships within core specialty markets to translate data into insight, enabling our clients to make smarter business decisions.

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