Initiation Of DMARDS Is Significantly Delayed In Treatment Of Rheumatoid Arthritis

Rheumatoid Arthritis

Decision Resources finds that the initiation of disease-modifying antirheumatic drugs (DMARDs) is significantly delayed despite guidelines that emphasize earlier and more aggressive treatment of rheumatoid arthritis (RA). According to the new report entitled Treatment Algorithms in Rheumatoid Arthritis, treatment of newly diagnosed RA patients takes, on average, 80 days to commence, and only 22.1 percent of patients receive a conventional or biologic DMARD as a first-line therapy. Remaining patients receive only palliative agents (e.g., nonsteroidal anti-inflammatory drugs and narcotic analgesics). However, surveyed primary care physicians (PCPs) and rheumatologists foresee increases in their use of both biologic and conventional DMARD therapy over the next two years.

The report also finds that Bristol Myers-Squibb's Orencia and Biogen Idec/Genentech/Chugai/Zenyaku Kogyo's Rituxan (marketed in Europe by Roche as MabThera) have made only limited inroads at all lines of therapy since their 2006 market entries, indicating that they are being used primarily in patients who fail to respond to TNF-alpha inhibitors.

"TNF-alpha inhibitors, led by Enbrel, will remain the leading biologic agents in the RA market through 2009," said Madhuri Borde, Ph.D., analyst at Decision Resources. "TNF-alpha inhibitors capture the vast majority of first-, second-, and third-line biologics use for RA; both PCPs and rheumatologists favor these agents because of their first-hand experience with the drugs and perception of these agents' efficacy in halting joint progression and relieving signs and symptoms of RA."

About Treatment Algorithm Insight Series

Decision Resources combines in-depth primary research with the most extensive claims-based longitudinal patient-level data from PharMetrics(R) to provide exceptional insight into physicians' prescribing trends and the factors that drive therapy product choice, from diagnosis through multiple courses of treatment, for a specific disease.

For each disease examined, Decision Resources' Treatment Algorithms Insight Series provides the following:

-- Summary of U.S. medical practice based on interviews with leading experts in the field.

-- Qualitative diagnosis/referral/treatment algorithm for the United States.

-- Drug usage by lines of therapy (1st, 2nd, 3rd line).

-- Discussion of key freeform combinations by lines of therapy.

-- Product share (class and specific compound level) within each line of therapy (1st, 2nd, 3rd line).

-- Progression of therapy from key 1st line products.

-- Pathway to key therapies from previous therapies.

-- Qualitative analysis of 2-year forecast incorporating upcoming launches, changes in reimbursement, etc.