Unmet needs in rheumatoid arthritis treatment could be addressed by first-in-class pipeline

RA remains an incurable condition with no therapeutics that directly act to restore bone content

The rheumatoid arthritis market is highly lucrative and significant advances in the understanding of the disease have greatly improved treatment options for a large number of patients during the past 20 years.

But serious unmet needs remain and there are still many opportunities for future drug developments, particularly for first-in-class innovation, according to business intelligence provider GBI Research.

The company’s latest report states that rheumatoid arthritis remains an incurable condition with no therapeutics that directly act to restore bone content and reduce cartilage degradation.

Safety, often concerning elevated infection as a result of immunosuppression, remains a concern, while many patients respond inadequately or eventually develop resistance to first- and second-line therapies. In addition, biologics require either intravenous or subcutaneous administration, which is often inconvenient and painful for patients.

Fiona Chisholm, analyst for GBI Research, explains: ‘The current disease pipeline is relatively large, containing 454 products. Although the proportion of first-in-class products in the pipeline is marginally lower than the industry average, it contains many first-in-class targets that have the potential to lead to therapeutic advances. In particular, there is a higher proportion and diversity of first-in-class molecular targets in the early development stages than in the clinical trial development stages.’

‘This is an encouraging trend, revealing sustained research and development in rheumatoid arthritis. Nonetheless, limited first-in-class innovation at the later development stages suggests that the therapeutic landscape will continue to be dominated by currently marketed products in the near future,’ she added.

GBI Research’s report also states that in terms of types of first-in-class products in the pipeline, cytokine and cytokine receptors, as well as protein kinases, largely dominate. Most first-in-class products targeting cytokines and their receptors are biologic therapies and target a range of mediators that underlie inflammatory and adaptive immune responses in rheumatoid arthritis.

Chisholm continues: ‘First-in-class products targeting protein kinases are predominantly orally administered small molecules and will be well-positioned to address the current unmet need for improved ease and convenience of drug delivery.’

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