26 February 2020

Upadacitinib joins expanding group of PsA drugs

The selective and reversible JAK inhibitor upadacitinib has had a promising start to the year.

In January, AbbVie’s upadacitinib was approved by the TGA for treatment of adult patients with moderate to severe active RA who have not responded or are intolerant to DMARDs.

In February, AbbVie released the results of a randomised, double-blind, placebo-controlled phase 3 study of upadacitinib in patients with psoriatic arthritis.

The study showed 30mg of upadacitinib once daily was a superior treatment to adalimumab in terms of ACR20 response at week 12, and 15mg of upadacitinib once daily was non-inferior.

At week 16, significantly more patients prescribed upadacitinib achieved PASI 75 compared with placebo.

Both doses of upadacitinib significantly inhibited radiographic progression at week 24 compared with placebo.

The safety profile was similar to those previously reported.

“The results showed that both doses of upadacitinib demonstrated significantly greater efficacy in joint and skin symptoms, as well as inhibition of radiographic progression, compared to placebo,” Iain McInnes, professor of experimental medicine and rheumatology at the University of Glasgow, said.

“These data are encouraging and add to the growing body of evidence that upadacitinib has the potential to improve outcomes for people living with psoriatic arthritis.”

There are ongoing phase 3 trials of upadacitinib for axial spondyloarthritis, Crohn’s disease, atopic dermatitis, ulcerative colitis and giant cell arteritis.

The PsA drug market is predicted to reach $9.2 billion by 2028, according to a report by UK-based consultancy GlobalData.

The company predicted that the growth will be partly driven by the launch of new drugs.

The JAK inhibitor class is expected to grow to $261 million by 2028, with AbbVie’s upadacitinib, Gilead’ filgotinib, and Pfizer’s brepocitinib tosylate joining Pfizer’s tofacitinib, which is the only JAK inhibitor currently available for PsA, according to GlobalData.

The growing class of injectable anti-interleukins, such as tildrakizumab, bimekizumab, ustekinumab, secukinumab, ixekizumab, is “set to challenge the branded TNF-inhibitors, the current standard of care”, GlobalData said.

“Combined with existing therapies, anti-interleukins are expected to earn $4.1 billion in 2028 and capture 60.9% of global PsA sales,” the company said.

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