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Rheumatoid Arthritis: KOL Insight [2018]

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Publication Date:
March 2018

How is Olumiant impacting the RA treatment landscape?

After several years on the US market, the availability of Pfizer’s Xeljanz in the EU is generally welcomed by KOLs; however, Eli Lilly/Incyte’s Olumiant (baricitinib) has managed to get first-to-market advantage in Europe. KOL’s weigh in on how Olumiant is faring in the EU, how its availability is impacting Xeljanz, as well as its chances to garner FDA approval. KOLs also examine Sanofi/Regeneron’s Kevzara (sarilumab) and how this new IL-6 inhibitor is faring. Furthermore, the experts discuss how AbbVie’s upadacitinib (ABT 494) and Galapagos/Gilead Sciences’ filgotinib shape up in an ever competitive JAK inhibitor market,  as well as how Can-Fite’s piclidenoson (CF 101) could disrupt the treatment paradigm. Experts also give their views on biosimilar anti-TNF uptake and the challenges branded anti-TNFs may face. Twelve US and European KOLs offer their candid insights on these issues and more.

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Top takeaways

  • Biosimilar anti-TNFs are now part of the treatment paradigm. How do KOLs  use these products and are there differences between US and European prescribing?
  • Cimzia and Simponi have no biosimilar competition. But what impact have other biosimilar anti-TNFs had on these two agents?
  • How well is Olumiant faring in Europe? Can Pfizer’s Xeljanz fend off competition from this product and will Olumiant be approved in the US? 
  • Actemra/RoActemra is a standard second-line therapy. But is usage expected to decline in the future, and what could Roche do to maintain market share? 
  • What impact has Kevzara had on the RA market? KOLs weigh in on Kevzara’s advantages/disadvantages and provide insights on current usage. 
  • Upadacitinib and filgotinib may provide specific advantages. Are these products perceived as real competitors to Xeljanz and Olumiant?
  • KOLs discuss future developments that may play a part in shaping the future treatment of RA. What are KOLs’ thoughts on future general trends and how will these impact RA treatment in the future? 
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“Upadacitinib is showing signs of JAK2 inhibition as well. Whether this is a good thing or a bad thing, nobody knows.”
European Key Opinion Leader

“Rituximab has always been kind of niche drug, especially in RA, it's more the end of the line. In RA it’s always going to be third or fourth line biologic.” 
US Key Opinion Leader

Sample of therapies covered

Marketed Therapies

  • Anti-TNFs
    • Humira (adalimumab; AbbVie)
    • Enbrel (etanercept; Amgen/Pfizer)
    • Remicade (infliximab; Janssen Biotech/Merck & Co.)
    • Cimzia (certolizumab pegol; UCB)
    • Simponi (golimumab; Janssen Biotech/Merck & Co.)
  • Biosimilar anti-TNFs: companies involved in biosimilar anti-TNFs: Sandoz; Amgen; Samsung Bioepis/Biogen; Celltrion/Pfizer; Boehringer Ingelheim
  • Actemra/RoActemra (tocilizumab; Roche)
  • Kevzara (sarilumab; Sanofi/Regeneron)
  • Orencia (abatacept; Bristol-Myers Squibb)
  • Rituxan/MabThera (rituximab; Roche/Biogen)
  • Xeljanz  (tofacitinib; Pfizer)
  • Olumiant (baricitinib; Incyte/Eli Lilly)

Pipeline Therapies

  • olokizumab (R-Pharm/UCB)
  • upadacitinib (ABT 494; AbbVie)
  • filgotinib (GLPG 0634; Galapagos/Gilead Sciences)
  • piclidenoson (CF 101; Can-Fite)

Earlier stage

  • mavrilimumab (CAM 3001; AstraZeneca)
  • Bruton kinase inhibitors (e.g. Merck Serono’s evobrutinib)

KOLs interviewed

KOLs from North America

  • Prof Michael E Weinblatt, MD, is Professor of Medicine at Harvard Medical School. Dr. Weinblatt serves as Co-director of Clinical Rheumatology at the Brigham and Women's Hospital.
  • Dr Petros Efthimiou, MD, is Associate Chief of Rheumatology at New York Methodist Hospital, and an Associate Professor of Medicine and Rheumatology at Weill Cornell Medical College.
  • Prof Fleischmann, MD, is Clinical Professor of Medicine at the University of Texas Southwestern Medical Center at Dallas, and co-Medical Director of the Metroplex Clinical Research Center in Dallas, TX.
  • Prof Jeffrey R Curtis, MD, is Professor of Medicine in the Division of Clinical Immunology and Rheumatology at the University of Alabama at Birmingham.
  • Dr Rohit Aggarwal MD, isAssociate Professor of Medicine and Medical Director, Arthritis and Autoimmunity Center, Division of Rheumatology, Department of Medicine at the University of Pittsburgh, Pittsburgh, PA, USA.
  • Dr Roberto Caricchio, MD, isInterim Section Chief, Rheumatology; Associate Professor, Medicine; Associate Professor, Microbiology and Immunology; and Director at Temple Lupus Clinic, Temple University, Philadelphia, PA, USA.

KOLs from Europe

  • Prof Paul Emery, is the Arthritis Research UK Professor of Rheumatology and Director of the Leeds Institute of Rheumatic and Musculoskeletal Medicine. He is also the Director of the Leeds Musculoskeletal Biomedical Research Unit at Leeds Teaching Hospitals Trust, UK.
  • Prof Tore K Kvien, is Professor of Rheumatology at the University of Oslo and Head of the Department of Rheumatology at Diakonhjemmet Hospital, Oslo, Norway.
  • Prof Ronald F van Vollenhoven, is Professor and Director of the Amsterdam Rheumatology and Immunology Center ARC; Chief of the Department of Rheumatology and Clinical Immunology at the AMC; and Head of the Department of Rheumatology at VUMC (VU University Medical Center) in Amsterdam, the Netherlands.
  • Prof Ferdinand Breedveld, is Professor and Head of the Department of Internal Medicine and Rheumatology at Leiden University Medical Centre, Leiden, the Netherlands.
  • Anonymous, German KOL, is a Professor of Medicine at a leading German university hospital.
  • Anonymous, German KOL, is a Professor of Medicine at a leading German university hospital.

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