As Anti-NGF Therapies Resume Phase III Trials, What Attributes of Emerging Therapies Will Most Influence Physician and Payer Decisions?
Osteoarthritis (OA) is a tremendously prevalent condition, affecting more than 70 million individuals in the major pharmaceutical markets, and one of its key characteristics is joint pain. Sales of therapies for the treatment of OA pain comprise the second largest segment of the chronic pain market. Despite the size of the market, however, a truly novel therapy has not emerged for this indication in more than a decade. Because nonsteroidal anti-inflammatory drugs (NSAIDs) and opioid analgesics are the predominant therapies used to manage OA pain, a significant amount of unmet need remains for therapies that lack the severe gastrointestinal, cardiovascular, and/or abuse risks associated with these current standards of care. Only one emerging class of agents—monoclonal antibodies against nerve growth factor (anti-NGFs)—has demonstrated the potential to improve on the efficacy, safety, and tolerability problems that plague the current therapies used to treat OA pain. However, the commercial success of the anti-NGFs in OA pain will ultimately hinge on overcoming the safety concerns unique to this class of agents as well as any hurdles to accessibility in an overwhelmingly genericized market.