Axial Spondyloarthritis | Unmet Need | Nonradiographic Axial Spondyloarthritis | US/EU5 | 2021

TNF-α inhibitors (AbbVie’s Humira, Amgen’s Enbrel, Janssen’s Remicade and Simponi, UCB’s Cimzia) are approved for the treatment of nonradiographic axial spondyloarthritis (nr-AxSpA) in Europe and are increasingly used off-label in the United States, where Cimzia is the only FDA-approved TNF-α inhibitor for nr-AxSpA. In addition, IL-17 inhibitors—Novartis’s Cosentyx and Eli Lilly’s Taltz—were recently approved for this subpopulation in both regions. In this report, we examine areas of unmet need in the treatment of nr-AxSpA, including short-term efficacy, improvement in patient-reported outcomes, mechanism of action, safety and tolerability, delivery, and price. With quantitative insight into U.S. and European rheumatologists’ assessment of the unmet need in nr-AxSpA, we discuss the commercial opportunities for this difficult-to-diagnose indication and how emerging therapies may capitalize on these opportunities.

For the abstract please provide an overview paragraph here and then fill in the bulleted sections below. Feel free to modify the bulleted section. Leverage content from a brochure if you have one.


  • What are the treatment drivers and goals for nr-AxSpA?
  • Which 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 nr-AxSpA?
  • What are the prevailing areas of unmet need and opportunity in nr-AxSpA?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European rheumatologists for a hypothetical new nr-AxSpA 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, United Kingdom, France, Germany

Primary research: Survey of 61 U.S. and 30 European rheumatologists fielded in March 2021.

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

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

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