Table of Contents
Executive Summary
- What is the current state of the SpA market?
- What opportunities remain in the SpA market?
- What are the challenges for developers of SpA therapies?
- What is the outlook for the SpA market?
- What companies are the current and emerging leaders of the SpA market?
- 1. Introduction
2. Overview of the Spondyloarthropathies
- Ankylosing Spondylitis
- Disease Definition, Pathophysiology, and Etiology
- Symptoms and Peripheral Involvement
- Diagnosis and Disease Progression
- Psoriatic Arthritis
- Disease Description and Etiology
- Symptoms
- Diagnosis and Disease Progression
- Reactive Arthritis
- Disease Description and Etiology
- Symptoms
- Joint Symptoms
- Eye Symptoms
- Skin Symptoms
- Diagnosis and Disease Progression
3. Epidemiology
- Ankylosing Spondylitis
- Psoriatic Arthritis
- Overview
- Disease Definition
- Methods
- Reactive Arthritis
- Overview
- Disease Definition
- Methods
4. Current Treatment Approaches
- Drug Classes Used to Treat Spondyloarthropathies
- Nonsteroidal Anti-Inflammatory Drugs
- Conventional Disease-Modifying Antirheumatic Drugs
- TNF-α Inhibitors
- Corticosteroids
- Bisphosphonates
- Medical Practice
- Ankylosing Spondylitis
- Treatment Goals
- NSAID Use in AS Treatment
- DMARD Use in AS
- TNF-α Inhibitor Use in AS
- Corticosteroid Use in AS
- Bisphosphonate Use in AS
- Psoriatic Arthritis
- Treatment Goals
- DMARD Use in PsA
- NSAID Use in PsA
- TNF-α Inhibitor Use in PsA
- Reactive Arthritis
- Treatment Goals
- NSAID Use in ReA
- DMARD Use in ReA
- TNF-α Use in ReA
5. Emerging Therapies for Spondyloarthropathies
- Centocor/Schering-Plough/Janssen/Mitsubishi Tanabe' s Simponi
- Findings and Outlook for AS
- Findings and Outlook for PsA
- Findings and Outlook for ReA
- Novartis' s AIN-457
- Findings and Outlook for AS
- Findings and Outlook for PsA
- Pozen/AstraZeneca' s PN-400
- Findings and Outlook for AS
- Array BioPharma' s ARRY-371797
- Findings and Outlook in AS
- Bristol-Myers Squibb' s Orencia
- Findings and Outlook for PsA
- Centocor/Medarex' s Stelara
- Findings and Outlook for PsA
- Celgene' s Apremilast
- Findings and Outlook for PsA
6. 2008 Market and Future Market Considerations
- Ankylosing Spondylitis
- Psoriatic Arthritis
- Reactive Arthritis
Appendix A. Bibliography
Tables and Figures
- Table 2-1. Criteria Used in Evaluating Ankylosing Spondylitis
- Table 2-2. Major Mediators in the Pathogenesis of Psoriatic Arthritis
- Table 2-3. Summary of the 2006 CASPAR Criteria for the Classification of
Psoriatic Arthritis
- Table 4-1. Nonsteroidal Anti-Inflammatory Agents Commonly Prescribed for
Spondyloarthropathies
- Table 4-2. Conventional Disease-Modifying Antirheumatic Drugs Commonly
Prescribed for Spondyloarthropathies
- Table 4-3. Marketed TNF-α Inhibitors
- Table 4-4. Relative Strengths and Weaknesses of TNF-α Inhibitors in
Ankylosing Spondylitis Treatment
- Table 4-5. TNF-α Inhibitors for Psoriatic Arthritis: Summary of
Clinical Trial Data
- Table 5-1. Agents in Active Development for the Treatment of
Spondyloarthropathies
- Table 6-1. Sales of Agents to Treat Spondyloarthropathies in the United
States and Europe, 2008
- Figure ES-1. Snapshot of the Spondyloarthropathy Markets
- Figure ES-2. Prevalent Cases of Spondyloarthropathies in the United States
and Europe, 2007
- Figure ES-3. Surveyed Rheumatologists' Willingness to Prescribe the
Emerging Agent Golimumab to Spondyloarthropathy Patients
- Figure 2-1. Rheumatologist-Estimated Percentage of Ankylosing Spondylitis
Patients with Specific Ankylosing Spondylitis Symptoms
- Figure 2-2. Rheumatologist-Estimated Percentage of Psoriatic Arthritis
Patients with Specific Psoriatic Arthritis Symptoms
- Figure 2-3. Rheumatologist-Estimated Percentage of Reactive Arthritis
Patients with Specific Reactive Arthritis Symptoms
- Figure 3-1. Total Prevalent Cases of Spondyloarthropathies in the Six
Major Markets, 2007 and 2017
- Figure 3-2. Prevalent Cases of Ankylosing Spondylitis in the United States
and Europe, 2007-2017
- Figure 3-3. Prevalent Cases of Psoriatic Arthritis in the United States
and Europe, 2007-2017
- Figure 3-4. Prevalent Cases of Reactive Arthritis in the United States and
Europe, 2007-2017
- Figure 4-1. Timeline of TNF-Alpha Approvals for Spondyloarthropathies in
the United States and Europe
- Figure 4-2. Survey Question: Please indicate your first-, second-, and
third-line therapy choice for the treatment of ankylosing spondylitis
- Figure 4-3. Survey Question: What percentage of your ankylosing
spondylitis patients require new or additional therapies within these time
frames?
- Figure 4-4. Surveyed Rheumatologist Opinion: Why TNF-Alpha Inhibitors Are
Not Prescribed as First-Line Therapy for Ankylosing Spondylitis
- Figure 4-5. Survey Question: Please indicate your first-, second-, and
third-line therapy choice for the treatment of psoriatic arthritis
- Figure 4-6. Survey Question: What percentage of your psoriatic arthritis
patients move to/add on a second-line therapy within the following time frames?
- Figure 4-7. Survey Question: What are the reasons why you do not prescribe
TNF-alpha inhibitors as a first-line therapy for psoriatic arthritis?
- Figure 4-8. Survey Question: Please indicate your first-, second-, and
third-line therapy choice for the treatment of reactive arthritis
- Figure 4-9. Survey Question: How many of your reactive arthritis patients
will require new or additional therapy within the following time frames?
- Figure 4-10. Survey Question: What percentage of your reactive arthritis
patients receive the following biologic therapies?
- Figure 5-1. Survey Question: Would you switch your ankylosing spondylitis
patients currently taking other tumor necrosis factor alpha inhibitors to
golimumab one the agent is available?
- Figure 5-2. Survey Question: If golimumab is approved for psoriatic
arthritis, will you prescribe it to your patients?
- Figure 5-3. Survey Question: Would you prescribe golimumab to your
reactive arthritis patients?
- Figure 5-4. Survey Question: Will you prescribe Novartis' s AIN-457 to your
ankylosing spondylitis patients?
- Figure 5-5. Survey Question: If AIN-457 is approved for psoriatic
arthritis, will you prescribe it to your patients?
- Figure 5-6. Survey Question: Will you prescribe Pozen' s PN-400 to your
ankylosing spondylitis patients?
- Figure 5-7. Survey Question: What agents do you think are most likely to
be replaced by Pozen' s PN-400?
- Figure 5-8. Survey Question: If apremilast is approved for psoriatic
arthritis, will you prescribe it to your patients?
- Figure 6-1. Spondyloarthropathy Market by Drug Class and TNF-α
Inhibitor Share, 2008
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