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With the High Efficacy Bar That TNF-Alpha Inhibitors Set, What Are the Remaining Areas of Opportunities for Emerging Therapies to Fill?

Nine biologics are approved to treat rheumatoid arthritis (RA), along with an oral kinase inhibitor (tofacitinib [Pfizer/Takeda’s Xeljanz]). Given rheumatologists’ long-standing familiarity with the safety and efficacy profiles of the TNF-α inhibitors, the first of which was approved in 1998, and, increasingly, of abatacept (Bristol-Myers Squibb/Ono Pharmaceutical’s Orencia), rituximab (Biogen Idec/Roche/Chugai/Zenyaku Kogyo’s Rituxan, Roche’s MabThera), and tocilizumab (Roche/Chugai’s RoActemra/Actemra), new agents face challenges in gaining uptake. To help drug developers negotiate the formidable barriers to uptake in this market, this report identifies attributes with the greatest power to sway rheumatologists’ prescribing decisions and the gaps in efficacy and safety of select current and emerging therapies.

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