Psoriasis: KOL Insight [2018]

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Publication Date:
July 2018
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How will next-generation biologics change the psoriasis treatment landscape? 

The treatment of psoriasis is evolving and the range of therapies is set to diversify with the approval and introduction of novel targeted treatment options. Is this a good thing, or will too much choice hamper effective treatment decisions? Will AbbVie’s Humira maintain its dominance after adalimumab biosimilars reach Europe in Q4 2018? Will IL-17 and IL-23 targeting therapies, like Cosentyx, Taltz, Tremfya and Ilumya, continue to gain ground? And within the late-stage development pipeline, which programmes are KOLs most excited about? Can next-generation IL-17 targeting treatments deliver anything new compared to currently used treatments? What do KOLs expect from risankizumab (AbbVie/Boehringer Ingelheim)? And within the oral therapies space, what do KOLs think about some of the innovative approaches -- including Tyk2 kinase inhibitors, RIP1 kinase inhibitors and macrophage modulators -- being developed, and their chances of success?

Twelve of the world’s leading KOLs from the US and Europe offer candid insights on 12 marketed therapies and 12 Phase II/III drugs in Psoriasis: KOL Insight [2018].

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Top takeaways

  • What next for branded anti-TNFs? As anti-TNF biosimilars gain traction in other indications, what does the future hold for branded anti-TNFs in the psoriasis treatment paradigm? Humira biosimilars are coming to Europe in October 2018, so how do KOLs expect these products to be used?
  • Can anti-IL-17s maintain market share in the face of new treatment approaches? The benefits of anti-IL-17 mAbs are clear, but do any concerns remain? And have rare adverse effects such as IBD and Crohn’s disease, dampened enthusiasm? KOLs predict a future tussle between the anti-IL-17 mAbs, but with which class of product?
  • Which anti-IL-23 mAb looks set to become the treatment of choice in psoriasis? KOLs are impressed with the safety and efficacy of Tremfya (guselkumab; Janssen Biotech/MorphoSys), but risankizumab (AbbVie/Boehringer Ingelheim) in on the horizon, and is coming to market with impressive safety and efficacy data, as well as a once every 12 weeks dosing schedule.
  • Will payers influence the uptake of pipeline psoriasis drugs? Patient access to biologics for psoriasis is far from adequate, argue KOLs, so what can payers do to improve things? Focus purely on costs and promote biosimilars, or look more closely at the data and allow patients to gain access to more effective treatments?
  • What have KOLs asked for from future treatments for psoriasis? Would KOLs prefer drugs that demonstrate long-term safety and disease remission, ones that allow for dosage flexibility and personalisation of treatment, or ones that are effective on the skin as well as joints?
  • Does the psoriasis treatment landscape have a differentiation problem? With so many treatment options becoming available, what are KOLs most concerned about when it comes to treatment decisions? And what can pharma companies do to support these decisions?
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“For now, since we have biosimilars that correspond to drugs that we're not using that much, it [impact] is minor. But that’s likely to change with the launch of Humira biosimilars.”
EU Key Opinion Leader

“Certainly, the risankizumab data seem to be spectacular, so I think that it will be a serious player. I think it's dosing [that matters most] but some of the enormous amount of persistence that you see as well. Whether these drugs are really modifying disease a little bit or not is a very interesting conceptual thing.”
EU Key Opinion Leader

Sample of therapies covered

Marketed Therapies:

  • Humira (adalimumab; AbbVie)
  • Enbrel (etanercept; Amgen/Pfizer)
  • Remicade (Merck & Co./Janssen Biotech)
  • Anti-TNF biosimilars (various)
  • Cimzia (certolizumab pegol; UCB)
  • Cosentyx (secukinumab; Novartis)
  • Taltz (ixekizumab; Eli Lilly)
  • Siliq/Kyntheum (brodalumab; Leo/AstraZeneca)
  • Stelara (ustekinumab; Janssen Biotech)
  • Otezla (apremilast; Celgene)
  • Tremfya (guselkumab; Janssen Biotech)
  • Ilumya (tildrakizumab; Sun/Merck & Co./Almirall)

Late Stage Pipeline Programmes:

  • Bimekizumab (UCB)
  • ABY 035 (Affibody)
  • ALX 0761 (Ablynx)
  • Risankizumab (AbbVie/Boehringer Ingelheim)
  • Mirikizumab (Lilly)

Early Stage Pipeline Programmes:

  • Piclidenoson (CanFite)
  • MP1032 (MetrioPharm)
  • BMS-986165 (BMS)
  • KD 025 (ROCK2 inhibitor; Kadmon)
  • GSK2982772 (RIP1 kinase inhibitor; GSK)
  • GR MD 02 (Galectin-3 inhibitor; Galectin)
  • PF 6700841 (Anti-TyK2/JAK1; Pfizer)

KOLs interviewed

KOLs from North America

  • Steven R Feldman. Professor of Dermatology, Professor of Pathology, Professor of Public Health Sciences, Social Science and Health Policy, Wake Forest Baptist Medical Center, Winston-Salem, NC
  • Joel M Gelfand. Professor of Dermatology, Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, PA
  • Alan Menter. Chairman of the Division of Dermatology, Baylor University Medical Center, Director of the Baylor Research Center, and Program Director of the Dermatology Residency Program, Baylor University Medical Center, Dallas, TX
  • Stephen Tyring. Professor of Dermatology, Department of Dermatology, University of Texas Health Science Center, Houston, TX
  • Jeffrey M Weinberg. Associate Clinical Professor Dermatology, Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
  • Jashin J Wu. Senior Dermatologist, Department of Dermatology, Kaiser Permanente Medical Center, Los Angeles, CA

KOLs from Europe

  • Hervé Bachelez. Professor of Dermatology, Department of Dermatology, Saint-Louis Hospital, Paris, France, and International Psoriasis Council Board Member
  • Pablo Coto-Segura. Associate Professor of Dermatology, Hospital Universitario Central Asturias, Oviedo, Spain
  • Robert Strohal. Head of the Department of Dermatology and Venereology, Federal University Teaching Hospital Feldkirch, Austria, and International Psoriasis Council Board Member
  • Richard Warren. Reader and Honorary Consultant Dermatologist, Division of Musculoskeletal & Dermatological Sciences, University of Manchester, UK
  • Anonymous German KOL. Professor and head of a division that focuses on the treatment of inflammatory conditions, including psoriasis, at a leading teaching and hospital in Germany
  • Anonymous German KOL. Head of a division that focuses on the treatment of inflammatory conditions, including psoriasis, psoriatic arthritis and atopic dermatitis, at a leading teaching and hospital in Germany

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