North American Psoriasis and Psoriatic Arthritis MarketsFrost & SullivanJuly 7, 2005 SKU: MC1164552 |
| Countries covered: North America Emerging Therapies Drive Revenue Growth Psoriasis and psoriatic arthritis affect an estimated 6.9 million people in North America, and despite its massive prevalence, the condition remains largely under-diagnosed. While the psoriasis treatment market has been static and generalized until recently, the introduction and increasing uptake of novel biologic response modifiers is driving revenue growth. Further, as there exists enormous opportunities for improved medications and treatment strategies, emerging therapies for these conditions are being developed in the market. These strategies address unmet medical concerns regarding safety (relating to highly toxic systemics that are currently in use), efficacy (addressing current topicals) duration of action (addressing patient interest in medications that induce remission), convenience (low frequency of dosing and self-administration), and cost (high cost of biologics). This Frost & Sullivan research service examines the North American markets for psoriasis and psoriatic arthritis therapies. The study analyzes the forces that are expected to shape the future of biologic and other emerging therapeutic categories in the treatment of psoriasis and psoriatic arthritis. The study also focuses on physician prescribing patterns and insights. Robust Drug Development Pipeline Fuels Market Growth Market interest in the treatment of psoriasis and psoriatic arthritis is relatively high and pharmaceutical and biotechnology companies are developing prospective drugs that offer enhanced safety profiles, longer relapse periods, and a more rapid medication onset. With over 25 products in the development pipeline, the market is considered very lucrative, as there are significant unmet medical needs. In addition, autoimmune and inflammatory diseases such as psoriasis, multiple sclerosis, inflammatory bowel disease, eczema, rheumatoid arthritis, and Crohn’s disease can be treated with similar medication, allowing companies to expand indications for existing medications and minimize developmental costs. However, despite the tremendous promise, there have been numerous setbacks among products in the later clinical stage. "Allergan Inc. has received a non-approvable letter from the FDA for its oral tazarotene and Serono’s Onercept, a promising tumor necrosis factor (TNF) inhibitor in phase III clinical trials was withdrawn due to safety concerns and sub-optimal efficacy observed then," says the analyst of this research service. "Similarly, Abgenix, Inc.ABX-IL8 (a monoclonal antibody specific to IL-8) and Genmab A/Ss HuMax-CD4 (a monoclonal antibody targeting CD4 receptor on T-lymphocytes were withdrawn after they failed phase IIb studies." Expanded Indications Hold Untapped Revenue Potential The psoriatic arthritis market has emerged with the launch of Enbrel (etanercept) as the first therapy approved for psoriatic arthritisin both the United States and Canada. Remicade (infliximab) recently gained approval in the United States and with over a million psoriatic arthritis patients in North America, addressing this market serves to increase revenues and strengthen the case for treatment products that have dual indications. Most companies are seeking the psoriatic arthritis indication first as a competitive strategy since patients with psoriatic arthritis also suffer from psoriasis. As a result, as physicians gain experience in assessing the dual properties of these drugs, they are likely to prescribe them off-label to their psoriasis patients. Although the number of patients seeking treatment is expected to grow, emerging product revenues are likely to be at the expense of traditional products, particular those with severe side effects. In addition to biologics, new oral systemics such as ISA247 (a cyclosporine analogue), BG-12 (a oral fumarate), and pimecrolimus (products that are likely to be launched between 2007 and 2008) are expected to significantly cut into the sales of methotrexate and cyclosporine in particular. "Around 40 percent of products in clinical trials for psoriasis and psoriatic arthritis are already marketed products seeking approval for an expanded indication," says the analyst. "Understanding primary care and dermatologist treatment patterns and insights are critical in competing effectively in this market."
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Additional Information
What's Included
- Detailed insights into recent developments and trends in the North American psoriasis and psoriatic arthritis therapies market
- Prescription patterns and dermatologist and primary care physician perceptions
- Analyst insights on emerging issues and new products being developed in the market
- Market sizing and competitive analysis
- Market forecasts and opportunity analysis
Market Sectors: Expert Frost & Sullivan analysts thoroughly examine the following market sectors in this research (By application):
- Plaque psoriasis
- Guttate psoriasis
- Erythrodermic psoriasis
- Inverse psoriasis
- Pustular psoriasis
- Psoriatic arthritis
Technologies: The following technologies are covered in this research:
- Biologic therapies: Medical preparations derived from living organisms. In psoriasis, this category of pharmaceuticals may target the immune system.
- Body surface area (BSA): The percent of body surface area affected by psoriasis. For example, if a person has a BSA of 10 percent or more, their psoriasis is classified as "severe." BSA is usually measured before and after treatment to determine the effectiveness of the therapy. The goal of successful psoriasis treatment is to reduce the percent of body surface area affected.
- Cytokines: A group of soluble, hormone-like proteins produced by white blood cells and that act as messengers between cells. Cytokines regulate the intensity and duration of immune responses and are involved in cell-to-cell communication.
- Emollient: An agent that holds moisture in the skin, and by doing so softens or soothes it.
- Erythrodermic psoriasis: The least common form of psoriasis in which the skin on almost the entire body becomes red and fiery. It may cause difficulty regulating the body’s temperature and heart rate. People with this type of psoriasis may require hospitalization.
- Guttate psoriasis: A type of psoriasis characterized by drop-like lesions on the trunk, limbs, and scalp. Symptoms may be triggered by viral respiratory infections or certain bacterial (streptococcal) infections.
- Inflammation: The protective response of the body’s tissue to irritation or injury, marked by four signs m - swelling, redness, heat, and pain.
- Inverse psoriasis: Psoriasis that occurs in the skin folds such as the underarm or groin area that can cause significant discomfort when one part of the skin rubs against another. When this occurs in the genital area, it can cause difficulty with sexual activities.
- Interferons: These are proteins released by cells in response to viral infection; activate the synthesis and secretion of antiviral proteins.
- Keratinocytes: The cells in the epidermis that manufacture the fibrous protein, keratin.
- Maintenance program: A treatment program that is initiated to keep a disease in remission after an intensive course of therapy.
- Psoriasis area and severity index (PASI): Includes the amount of body surface area affected by psoriasis in addition to three major symptoms: redness, inflammation, and the thickness of the skin’s scale. A patient is given a PASI score from 0-72 where 0 means no psoriasis and 72 stands for the most severe psoriasis. A PASI score is given to a patient before and after treatment to determine the effectiveness of the therapy. The goal of successful psoriasis treatment is to reduce the PASI score as close to 0 as possible.
- Physician’s global assessment (PGA): A measurement tool used in psoriasis clinical studies to evaluate efficacy of medication. PGA has a 7-point scale with a score of 0 meaning there are no signs of psoriasis and a score of 6 standing for signs of severe psoriasis. The goal of successful psoriasis treatment is to reduce the PGA score as close to 0 as possible.
- Phototherapy: The use of natural or artificial UV light to treat diseases.
- Plaque psoriasis: The most common form of psoriasis, also known as psoriasis vulgaris and recognized by red and raised lesions covered by silvery scales. About 80 percent of psoriasis patients have this type.
- Psoriasis: A chronic skin disease characterized by inflammation and scaling. Scaling occurs when cells in the outer layer of skin reproduce faster than normal and pile up on the skin’s surface. It is understood to be a disorder of the immune system.
- Psoriatic arthritis: A disease characterized by stiffness, pain, and swelling in the joints - especially of the hands and feet. It affects about 30 percent of people with psoriasis. Early diagnosis and treatment can help inhibit the progression of joint deterioration.
- Pustular psoriasis: A type of psoriasis characterized by blisters of pus on the skin, usually on the palms or soles of the feet. The pustules are not infectious.
- Psoralen plus ultraviolet A (PUVA): A treatment that combines exposure to ultraviolet A (UVA) light with a medicine called psoralen. Psoralen is believed to heighten photosensitivity and increase the skin’s response to UVA for people with moderate to severe psoriasis.
- Rebound (In reference to skin psoriasis): A severe and sudden change that occurs in psoriasis when systemic therapy is suddenly halted. This change leaves the patient’s psoriasis in a significantly worse condition than before the treatment was started. Rebound may also include a change in the nature of the psoriasis, for example, a change from plaque to pustular form.
- Remission: A lessening or abatement of the symptoms of a disease.
- Rotational therapy: A strategy in which a doctor rotates a patient’s treatments periodically to reduce toxicity and to allow for longer periods of benefit from each agent.
- T cell: A type of white blood cell, which is part of the immune system that normally helps protect the body against infection and disease.
- Thrombocytopenia: A disorder sometimes associated with abnormal bleeding in which the number of platelets (cells that help blood clot) is abnormally low.
- Tumor necrosis factor (TNF): One of the cytokines, known to be fundamental to the disease process that underlies psoriasis. It often plays a key role in the onset and the continuation of skin inflammation.
- Ultraviolet (UV) light: The type of light that emanates directly from the sun. It is classified into three categories according to wavelength: UVC, UVB, and UVA. Ultraviolet light can also be simulated using light panels and light boxes. This is a popular treatment for psoriasis.
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