DelveInsight’s ‘Rheumatoid Arthritis (RA) - Market Insights, Epidemiology and Market Forecast—2030’ report delivers an in-depth understanding of the RA, historical and forecasted epidemiology as well as the RA market trends in the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan.
The RA market report provides current treatment practices, emerging drugs, RA market share of the individual therapies, current and forecasted RA market size from 2017 to 2030 segmented by seven major markets. The Report also covers current RA treatment practice/algorithm, market drivers, market barriers and unmet medical needs to curate best of the opportunities and assesses underlying potential of the market.
• The United States
• EU5 (Germany, France, Italy, Spain and the United Kingdom)
Study Period: 2017–2030
Rheumatoid Arthritis (RA): Disease Understanding and Treatment Algorithm
Rheumatoid Arthritis Overview
Rheumatoid arthritis (RA) is an autoimmune or chronic inflammatory disease that is known to impact the joints of the body adversely. An autoimmune disorder is a condition where the immune system starts making antinuclear bodies instead of antibodies which directs them to cause self-injury to the body, on the onset of disease, the immune response primarily attacks and harm the joints. RA is more common in women and about 75% of RA patients are women. Around 1 to 3% of women may get rheumatoid arthritis in their lifetime. The disease most often begins between the ages of 30 and 50. However, RA can start at any age.
Clinically, the symptoms of RA significantly differ between early-stage RA and insufficiently treated later stages of the disease. Early-stage RA is characterized by generalized disease symptoms such as fatigue, flu-like feeling, swollen and tender joints, and morning stiffness; and is paralleled by elevated levels of C-reactive protein (CRP) and an increased erythrocyte sedimentation rate (ESR). In contrast, insufficiently treated RA displays a complex clinical picture with the occurrence of serious systemic manifestations such as pleural effusions, lung nodules and interstitial lung disease, lymphomas, vasculitis in small or medium-sized arteries, keratoconjunctivitis, atherosclerosis, hematologic abnormalities (e.g., anemia, leukopenia, neutropenia, eosinophilia, thrombocytopenia, or thrombocytosis), joint misalignments, loss of range of motion, bone erosion, cartilage destruction, and rheumatic nodules. These systemic manifestations caused by the chronic inflammatory state in RA patients result in increased mortality.
Rheumatoid Arthritis Diagnosis
Typically, RA is diagnosed by a combination of patient’s symptoms, results of doctor´s examination, assessment of risk factors, family history, a joint assessment by ultrasound sonography, and assessment of laboratory markers such as elevated levels of CRP and ESR in serum and detection of RA-specific autoantibodies.
More than two thirds of RA patients have reported moderate to severe symptoms and having disease activity (DAS) score of 3.2 or above. And by this stage, most of the patients have joints that are experiencing swelling and pain and may have deformities, like malalignment, in some joints as a result of cartilage destruction.
The RA epidemiology division provides the insights about historical and current RA patient pool and forecasted trend for each seven major countries. It helps to recognize the causes of current and forecasted trends by exploring numerous studies and views of key opinion leaders. This part of the DelveInsight report also provides the diagnosed patient pool and their trends along with assumptions undertaken.
In the year 2017, the total prevalent cases of RA was 4,356,793 cases in the 7MM which are expected to grow during the study period, i.e., 2017–2030.
The disease epidemiology covered in the report provides historical as well as forecasted RA epidemiology segmented as [Total Prevalent Cases of RA, Diagnosed cases of RA, Gender-specific cases of RA, Diagnosed cases of RA by Age Distribution, Severity-specific cases of RA, Patients on targeted therapies of RA, and Line-Wise Treated Cases of RA] scenario of RA in the 7MM covering the United States, EU5 countries (Germany, France, Italy, Spain, and the United Kingdom), and Japan from 2017 to 2030.
Country Wise- RA Epidemiology
Estimates show that the highest cases of RA in the 7MM were in the United States, followed by Japan, Germany, the United Kingdom, France, Italy, and Spain in 2017.
• The United States, in 2017, accounted for 1,333,290 RA prevalent cases, which are expected to grow during the study period, i.e., 2017–2030.
• In the year 2017, the total prevalent cases of RA in EU5 were 1,956,920, which are expected to grow during the study period, i.e., 2017–2030.
• In the year 2017, the total prevalent cases of RA in Japan were 1,066,584, which are expected to grow during the study period, i.e., 2017–2030.
RA Drug Chapters
Drug chapter segment of the RA report encloses the detailed analysis of RA marketed drugs and late stage (Phase-III and Phase-II) pipeline drugs. It also helps to understand the RA clinical trial details, expressive pharmacological action, agreements and collaborations, approval and patent details, advantages and disadvantages of each included drug and the latest news and press releases.
RA Approved Drugs
Olumiant/Baricitinib (Eli Lilly and Company/Incyte Corporation)
Xeljanz/Tofacitinib (Pfizer/PF Prism CV)
Remicade/Infliximab (Janssen Biotech/Centocor)
Simponi/Golimumab (Jannsen Biotech)
Orencia/Abatacept (Bristol Myers Squibb)
Smyraf/Peficitinib (Astellas Pharma)
Kineret/Anakinra (Amgen/Swedish Orphan Biovitrum AB)
Kevzara/Sarilumab (Regeneron and Sanofi/Asahi Kasei Pharma)
Note: Detailed Current therapies assessment will be provided in the full report of RA
RA Emerging Drugs
Filgotinib/GS-6034/GLPG0634/Jyseleca (Gilead and Galapagos NV)
Olokizumab (R Pharm)
Ozoralizumab/TS-152 (Taisho Pharmaceuticals/Ablynx)
ATI-450/CDD-450 (Aclaris Therapeutics)
VIB4920 (Viela Bio)
Branebrutinib (Bristol Myers Squibb)
ABBV-3373 and ABBV-154 (AbbVie)
JTE-051 (Akros Pharma/Japan Tobacco)
MPC-300-IV/ Allogeneic Mesenchymal Precursor Cells (Mesoblast)
Bimekizumab (UCB Pharma/PRA HEALTH SCIENCES)
Namilumab/IZN-101/AMG203 (Izana Bioscience/Takeda)
HB-AdMSCs (Hope Biosciences)
Note: Detailed emerging therapies assessment will be provided in the final report.
RA Market Outlook
RA is an autoimmune disease for which several effective treatment options are present. Currently, there are three primary treatment options for severe and advancing RA which include DMARDs, NSAIDs, and corticosteroids. Early treatment of RA patients with DMARDs significantly decreases these complications. Methotrexate is an excellent, economical first-line DMARD used to treat a majority of RA patients. While most patients respond well to MTX, many continue to have active disease.
DMARDs are immunosuppressive and immunomodulatory agents and are classified as either conventional DMARDs or biologic DMARDs. Biologic DMARDs are rapidly effective in retarding the progression of the joint damage caused by RA. Tumor necrosis factor (TNF) is a messenger protein that promotes inflammation in joints. Biologic medications such as Enbrel (etanercept), Remicade (infliximab), Humira (adalimumab), Simponi (golimumab), and Cimzia (certolizumab pegol) are all TNF inhibitors that prevent the recruitment of the cells that cause inflammation, bringing rapid symptom relief. It is worth noting that, prior to 2009, Enbrel, Remicade, and Humira were only three TNF inhibitors dominating the market of RA in the United States. Apart from this, T-cell costimulatory blocking agents (Orencia), B-cell depleting agents (Rituxan), interleukin-6 (IL-6) inhibitors (Actemra), and interleukin-1 (IL-1) receptor antagonists (Kineret), have also been approved over the past few years for the management of RA.
Companies like GlaxoSmithKline [Otilimab (MOR103/GSK3196165)], Taisho Pharmaceutical [Ozoralizumab (TS-152)], Gilead and Galapagos NV [Filgotinib (GS-6034; Jyseleca)], and R-Pharm (Olokizumab) with their key candidates are in registrational or late clinical-stage. In addition to this, companies like Merck KGaA (Evobrutinib), Pfizer (PF-06650833, and PF-06651600), Roche (Fenebrutinib), and several others in phase II clinical development stage with their investigational candidates.
In conclusion, it can be summarized that as many potential therapies are being investigated for the management of RA, it is safe to predict that the treatment space will experience a significant impact during the forecast period of 2020–2030.
The RA market size in the 7MM is expected to change during the study period 2017–2030. The therapeutic market of RA in the seven major markets was USD 21,184.4 million in 2017 which is expected to increase during study period (2017–2030). According to the estimates, the highest market size of RA is found in the United States followed by Japan and Germany.
The United States Market Outlook
In 2017, the total market size of RA therapies was USD 13,152 million in the United States which is expected to increase in the study period (2017–2030).
EU-5 Countries: Market Outlook
In 2017, the total market size of RA therapies was USD 5,038.2 million in the EU-5 countries which is expected to increase in the study period (2017–2030).
Japan Market Outlook
The total market size of RA therapies in Japan was USD 2,994.6 million in 2017 which is expected to increase in the study period (2017–2030).
RA Pipeline Development Activities
The drugs which are in pipeline include:
1. Otilimab/GSK3196165 (GlaxoSmithKline)
2. Filgotinib/GS-6034/GLPG0634/Jyseleca (Gilead and Galapagos NV)
3. Olokizumab (R Pharm)
4. Ozoralizumab/TS-152 (Taisho Pharmaceuticals/Ablynx)
5. ATI-450/CDD-450 (Aclaris Therapeutics)
6. VIB4920 (Viela Bio)
7. Branebrutinib (Bristol Myers Squibb)
8. ABBV-3373 and ABBV-154 (AbbVie)
9. Dekavil/F8IL10 (Pfizer/Philogen)
10. PF-06651600/Ritlecitinib (Pfizer)
11. JTE-051 (Akros Pharma/Japan Tobacco)
12. Evobrutinib/M2951 (Merck)
13. PF-06650833 (Pfizer)
14. Fenebrutinib/GDC-0853/RG7845 (Roche/Genentech)
15. MPC-300-IV/ Allogeneic Mesenchymal Precursor Cells (Mesoblast)
16. Bimekizumab (UCB Pharma/PRA HEALTH SCIENCES)
17. Namilumab/IZN-101/AMG203 (Izana Bioscience/Takeda)
18. ABX464 (Abivax)
19. HB-AdMSCs (Hope Biosciences)
20. SKI-O-703 (Genosco/Oscotec)
Note: Detailed emerging therapies assessment will be provided in the final report.
RA Drugs Uptake
Among the recently launched and upcoming therapies, upadacitinib and filgotinib has the potential to impact the market owing to more selective oral JAK1 inhibitor and better clinical profile compared to already approve JAKi. Although upadacitinib will have slight edge over filgotinib owing to order of entry and slightly better efficacy data.
Access and Reimbursement Scenario in RA Therapies
European League Against Rheumatism (EULAR) updated recommendations for the management of rheumatoid arthritis (RA) with synthetic and biologic disease-modifying antirheumatic drugs (DMARDs).
Leflunomide or sulfasalazine was considered as part of first-line treatment if patients experience early intolerance. Other conventional synthetic DMARDs in the absence of poor prognostic factors was recommended if the treatment target was not achieved after the first-line conventional synthetic DMARD strategy.
A biologic DMARD or a targeted synthetic DMARD was recommended if poor prognostic factors were present, and the treatment target was not achieved with the first conventional synthetic DMARD strategy. The targeted synthetic DMARDs include tofacitinib and baricitinib, synthetic DMARDs specifically designed to target Janus kinases.
EULAR recommended that biologic DMARDs and targeted synthetic DMARDs be combined with a conventional synthetic DMARD as all biologic and targeted synthetic DMARDs are more efficacious in combination therapy compared with monotherapy.
According to EULAR, if a biologic DMARD or targeted synthetic DMARD therapy fails, treatment with another biologic DMARD or targeted synthetic DMARD should be considered. Similarly, if treatment with tumor necrosis factor inhibitor (TNFi) fails, patients may be effectively treated with a different mode of action or a second TNFi therapy.
The National Institute for Health and Care Excellence has recommended Rinvoq, added to standard-of-care methotrexate, for coverage on the National Health Service as a treatment for severe rheumatoid arthritis in January 2020.
In the UK, Sarilumab with methotrexate, was recommended by NICE in 2017 as an option for treating active rheumatoid arthritis in adults whose disease has responded inadequately to intensive therapy with a combination of conventional disease-modifying antirheumatic drugs (DMARDs), only if:
• The disease is severe (a disease activity score [DAS28] of more than 5.1) and
• The company provides sarilumab with the discount agreed in the patient access scheme.
• In 2018, an added benefit for Tofacitinib in combination with methotrexate after pretreatment with a conventional synthetic DMARD or with a biological DMARD was not proven for the treatment of adults who have had an inadequate response or who have been intolerant to a prior DMARD therapy by IQWIG, Germany.
• In 2019, IQWIG reported hint of minor added benefit after pretreatment with a conventional synthetic DMARD for Tofacitinib in combination with methotrexate in adults who have had an inadequate response or who were intolerant to a prior DMARD therapy.
• In 2017, IQWIG reported hint of an added benefit for Sarilumab in patients for whom treatment with biologic disease-modifying antirheumatic drugs (bDMARD) is indicated for the first time and who do not tolerate MTX. Added benefits were not proven for other patient groups.
Note: Detailed Access and Reimbursement Scenario will be provided in the final report.
To keep up with current market trends, we take KOLs and SME’s opinion working in RA domain through primary research to fill the data gaps and validate our secondary research. Their opinion helps to understand and validate current and emerging therapies treatment patterns or RA market trend. This will support the clients in potential upcoming novel treatment by identifying the overall scenario of the market and the unmet needs.
Competitive Intelligence Analysis
We perform Competitive and Market Intelligence analysis of the RA Market by using various Competitive Intelligence tools that includes – SWOT analysis, PESTLE analysis, Porter’s five forces, BCG Matrix, Market entry strategies etc. The inclusion of the analysis entirely depends upon the data availability.
Scope of the Report
• The report covers the descriptive overview of RA, explaining its causes, signs and symptoms, pathophysiology and currently available therapies.
• Comprehensive insight has been provided into the RA epidemiology and treatment in the 7MM.
• Additionally, an RA-inclusive account of both the current and emerging therapies for RA is provided, along with the assessment of new therapies, which will have an impact on the current treatment landscape.
• A detailed review of RA market; historical and forecasted is included in the report, covering drug outreach in the 7MM.
• The report provides an edge while developing business strategies, by understanding trends shaping and driving the global RA market.
• In the coming years, RA market is set to change due to the rising awareness of the disease and incremental healthcare spending across the world; which would expand the size of the market to enable the drug manufacturers to penetrate more into the market.
• The companies and academics are working to assess challenges and seek opportunities that could influence RA R&D. The therapies under development are focused on novel approaches to treat/improve the disease condition.
• Major players are involved in developing therapies for RA. Launch of emerging therapies, will significantly impact the RA market.
• A better understanding of disease pathogenesis will also contribute to the development of novel therapeutics for RA.
• Our in-depth analysis of the pipeline assets across different stages of development (Phase III and Phase II), different emerging trends and comparative analysis of pipeline products with detailed clinical profiles, key cross-competition, launch date along with product development activities will support the clients in the decision-making process regarding their therapeutic portfolio by identifying the overall scenario of the research and development activities.
RA Report Insights
• Patient Population
• Therapeutic Approaches
• RA Pipeline Analysis
• RA Market Size and Trends
• Market Opportunities
• Impact of upcoming Therapies
RA Report Key Strengths
• 11 Years Forecast
• 7MM Coverage
• RA Epidemiology Segmentation
• Key Cross Competition
• Highly Analyzed Market
• Drugs Uptake
RA Report Assessment
• SWOT Analysis
• Current Treatment Practices
• Unmet Needs
• Pipeline Product Profiles
• Conjoint Analysis
• Market Attractiveness
• Market Drivers and Barriers
• What was the RA Market share (%) distribution in 2017 and how it would look like in 2030?
• What would be the RA total market size as well as market size by therapies across the 7MM during the study period (2017–2030)?
• What are the key findings pertaining to the market across the 7MM and which country will have the largest RA market size during the study period (2017–2030)?
• At what CAGR, the RA market is expected to grow in the 7MM during the study period (2017–2030)?
• What would be the RA market outlook across the 7MM during the study period (2017–2030)?
• What would be the RA market growth till 2030 and what will be the resultant market size in the year 2030?
• How would the market drivers, barriers and future opportunities affect the market dynamics and a subsequent analysis of the associated trends?
• RA patient types/pool where unmet need is more and whether emerging therapies will be able to address the residual unmet need?
• How emerging therapies are performing on the parameters like efficacy, safety, route of administration (RoA), treatment duration and frequencies on the basis of their clinical trial results?
• Among the emerging therapies, what are the potential therapies which are expected to disrupt the RA market?
• What is the disease risk, burden and unmet needs of the RA?
• What is the historical RA patient pool in the seven major markets covering the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom) and Japan?
• What would be the forecasted patient pool of RA in the 7 major markets covering the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom) and Japan?
• What will be the growth opportunities in the 7MM with respect to the patient population pertaining to RA?
• Out of all the 7MM countries, which country would have the highest prevalent population of RA during the study period (2017–2030)?
• At what CAGR the population is expected to grow in the 7MM during the study period (2017–2030)?
• What are the various recent and upcoming events which are expected to improve the diagnosis of RA?
Current Treatment Scenario and Emerging Therapies:
• What are the current options for the treatment of RA?
• What are the current treatment guidelines for the treatment of RA in the US, Europe and Japan?
• How many companies are developing therapies for the treatment of RA?
• How many therapies are developed by each company for the treatment of RA?
• How many emerging therapies are in mid stage, and late stage of development for the treatment of RA?
• What are the key collaborations (Industry–Industry, Industry–Academia), Mergers and acquisitions, licensing activities related to the RA therapies?
• What are the recent novel therapies, targets, mechanisms of action and technologies developed to overcome the limitation of existing therapies?
• What are the clinical studies going on for RA and their status?
• What are the key designations that have been granted for the emerging therapies for RA?
• What is the global historical and forecasted market of RA?
Reasons to buy
• The report will help in developing business strategies by understanding trends shaping and driving the RA market.
• To understand the future market competition in the RA market and Insightful review of the key market drivers and barriers.
• Organize sales and marketing efforts by identifying the best opportunities for RA in the US, Europe (Germany, France, Italy, Spain, and the United Kingdom) and Japan.
• Identification of strong upcoming players in market will help in devising strategies that will help in getting ahead of competitors.
• Organize sales and marketing efforts by identifying the best opportunities for RA market.
• To understand the future market competition in the RA market.
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