Axial Spondyloarthritis – Unmet Need – Axial Spondyloarthritis | Unmet Need | Ankylosing Spondylitis | US/EU | 2022

In the last 20 years, TNF-α inhibitors (AbbVie’s Humira, Amgen / Pfizer’s Enbrel, Janssen’s Remicade and Simponi, UCB’s Cimzia) have transformed the treatment of ankylosing spondylitis (AS) and brought new attention to this autoimmune disease. The IL-17 inhibitors (Novartis’s Cosentyx and Eli Lilly’s Taltz) offer an alternative mechanism of action to TNF-α inhibition and are relatively new to the market. Today, oral targeted therapies—e.g., JAK inhibitors (AbbVie’s Rinvoq and Pfizer’s Xeljanz)—are approved for AS; these agents’ success will be shaped by the remaining unmet needs in the treatment of this population. In this report, we examine areas of unmet need in the treatment of AS, including short-term efficacy, patients’ quality of life, mechanism of action, safety and tolerability, delivery, and price. With quantitative insight into U.S. and European rheumatologists’ assessment of the unmet need in AS, we discuss the commercial opportunities for this enigmatic indication and how emerging therapies may capitalize on these opportunities.


  • What are the treatment drivers and goals for AS?
  • What drug attributes are key influencers, which have limited impact, and which are hidden opportunities?
  • How do current therapies perform on key treatment drivers and goals for AS?
  • What are the prevailing areas of unmet need and opportunity in AS?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European rheumatologists for a hypothetical new AS drug?


Unmet Need supports clinical development decisions by identifying key attributes and assessing areas of unmet need for a specific disease or subpopulation. Based on surveys with U.S. and European physicians, this report provides insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities. One market scenario is profiled in detail by Clarivate experts, and additional customized market scenarios can be evaluated with the corresponding TPP simulator.

Markets covered: United States, France, Germany, United Kingdom

Primary research: Survey of 60 U.S. and 30 European rheumatologists fielded in February 2022.

Key companies: AbbVie, Amgen, Janssen, UCB, Novartis, Eli Lilly

Key drugs: Humira, Enbrel, Remicade, Cimzia, Cosentyx, Taltz, Rinvoq

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