What dermatologists are prescribing in the EU5 for psoriasis

[Fred]

This report surveyed dermatologists in the EU5 (France, Germany, Italy, Spain, United Kingdom) to find out what they are prescribing for psoriasis patients not responding to creams and light treatments.

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Decision Resources Group finds that in the EU5, while surveyed dermatologists prefer subcutaneous TNF-alpha inhibitors AbbVie's Humira and Amgen/Pfizer's Enbrel for first-line treatment, Janssen Biotech's Stelara is also seeing increasing use in earlier-lines of therapy, driven by favorable efficacy and safety, increasing physician familiarity and convenient dosing. Among the biologics, Humira is the patient share leader, followed by Enbrel and Stelara. However, Novartis's Cosentyx, the first-in-class IL-17 inhibitor, has steadily captured market share as it gradually becomes available to dermatologists in the EU5. Celgene's Otezla, an oral PDE-4 inhibitor, is seeing only limited usage in moderate and severe patients probably because its access is limited across the EU5. However, unlike biologics, it is seeing comparable use in both the moderate and severe sub-populations.

Other key findings from the Current Treatment report:

According to surveyed EU5 dermatologists, psoriasis is the most prevalent primary condition treated by them. Common risk factors and comorbidities are family history of psoriasis, smoking, obesity, hypertension, depression, hyperlipidemia, alcohol use, psoriatic arthritis and diabetes.
   
When treating psoriasis, surveyed dermatologists tend to report earlier-line use of the biologics with which they have the most experience—Humira and Enbrel—followed by Stelara. Remicade is generally reserved as a later-line therapy. The more recently launched drugs Otezla and Cosentyx tend to be used as later-line therapies, though Otezla is seeing some use before biologics, particularly in Germany.
   
Typically, the most commonly encountered step therapy requirement for TNF-α inhibitors and Stelara is failure with two or more conventional systemic therapies. For the newest biologic, Cosentyx, step therapy measures are different compared with the requirements indicated for the established biologics and often vary from country to country.
   
Overall in the EU5, according to the surveyed dermatologists' predictions, across the spectrum of disease severity, patient share of biologics is expected to increase in one year's time from the 2016 baseline.

Comments from Decision Resources Group Analyst Sangha Mitra, Ph.D., MBA:

"Patients initiating treatment with Cosentyx have a range of treatment histories: switching from Stelara or Humira, or even naïve to biologic and Otezla treatment. In contrast, patients who begin therapy with Otezla are frequently being switched from conventional systemic therapy, or are biologic-naïve."
   
"Our research shows that the main prescribing drivers for initiating patients on Cosentyx are its efficacy and novel mechanism of action. For Otezla, key drivers cited are novel mechanism of action, safety profile and unsurprisingly the convenience of oral formulation."

Source: prnewswire.com