Image

THE IMMUNO-INFLAMMATION MARKET

A steadily expanding market

Overview of the industry landscape in 2018 & future outlook

A market dominated by monoclonal antibodies

Figure 1: Top 20 immuno-inflammation sales (2017 projections in millions of dollars. Source: Global Data, 2018)

Figure 1: Top 20 immuno-inflammation sales
(2017 projections in millions of dollars. Source: Global Data, 2018)

Immuno-inflammatory diseases affect between 5% and 7% of the western population. Despite their diverse symptoms and geographical incidence, what all these diseases have in common is that they deregulate the immune response. The many indications include rheumatoid arthritis, Crohn’s disease, psoriasis, asthma, and multiple sclerosis, to name but a few. The first therapeutic options available generally featured a treatment with glucocorticoids. Most of these drugs now face competition from generics and they are ineffective over the long term. A second-generation of therapies was introduced in 1998 with the approval of anti-TNF monoclonal antibodies, such as J&J’s Remicade and Amgen’s Enbrel. These drugs achieved commercial success thanks to their still widespread use today and their high cost (Figure 1). They were followed by Abbvie’s Humira, which gained marketing approval in 2002. Even so, use of these treatments with their accessibility issues (intravenous injection, high production cost) and significant side effects in certain cases has been confined to a subset of patient categories.

A third-generation of treatments has won market share since 2005. They are interleukin inhibitor antibodies (Stelara, Actemra, Consentyx, etc.) known for their safety, which generated 19% of sales in 2017.

Image

JAK-1 kinase inhibitors, the first kinase inhibitors in the immuno-inflammation market

Despite doctors’ reluctance to change a stable patient’s treatment, analysts anticipate growing interest in small kinase inhibitor molecules. Since they are administered orally, and their side effects have improved significantly, this fourth-generation of treatments could even become a first-line treatment in certain indications, if its efficacy were confirmed in clinical trials2.

Another approach to small kinase inhibitors for immuno-inflammatory diseases has opened up a new line of attack over the past few years and raised the prospect of success for this type of approach: Pfizer has marketed Xeljanz (tofacitinib), a JAK1 (Janus Kinase 1) kinase inhibitor since 2012 in the United States as a treatment for rheumatoid arthritis. Its sales have grown rapidly to reach $1.35 billion in 2017. In the same year, the FDA approved Xeljanz as a treatment for ulcerative colitis and psoriatic arthritis. Also, in 2017, Pfizer finally gained marketing approval in the European market to treat patients with rheumatoid arthritis… five years after its launch in the US.Another approach to small kinase inhibitors for immuno-inflammatory diseases has opened up a new line of attack over the past few years and raised the prospect of success for this type of approach: Pfizer has marketed Xeljanz (tofacitinib), a JAK1 (Janus Kinase 1) kinase inhibitor since 2012 in the United States as a treatment for rheumatoid arthritis. Its sales have grown rapidly to reach $1.35 billion in 2017. In the same year, the FDA approved Xeljanz as a treatment for ulcerative colitis and psoriatic arthritis. Also, in 2017, Pfizer finally gained marketing approval in the European market to treat patients with rheumatoid arthritis… five years after its launch in the US.
Thanks to the spectacular growth in its sales and its multiple indications, Xeljanz has played a key role in educating practitioners in how to use orally-administered small kinase inhibitors as immuno-inflammation therapies. Analysts forecast sales of $3.07 billion in 2023 for Xeljanz, with a major increase in the market share gained by JAK inhibitors.

RIPK2 kinase inhibitors: a new target of interest for oncodesignRIPK2 kinase inhibitors: a new target of interest for oncodesign

RIPK2 (or RIP2, Receptor Interacting Kinase 2) is a kinase that plays a part in the innate immune system. It features in a pathway activated when a bacterial infection occurs, and its role is to eliminate the infected cells. Nonetheless, this natural line of defense could be responsible for a number of autoimmune diseases, as several genetic and pharmacological studies have suggested in the latest scientific literature. So the inhibition of this kinase represents a new opportunity for therapeutic intervention in various immuno-inflammation indications. As a result, it’s a major avenue of research in the pharma sector.RIPK2 (or RIP2, Receptor Interacting Kinase 2) is a kinase that plays a part in the innate immune system. It features in a pathway activated when a bacterial infection occurs, and its role is to eliminate the infected cells. Nonetheless, this natural line of defense could be responsible for a number of autoimmune diseases, as several genetic and pharmacological studies have suggested in the latest scientific literature. So the inhibition of this kinase represents a new opportunity for therapeutic intervention in various immuno-inflammation indications. As a result, it’s a major avenue of research in the pharma sector.

GSK has currently made the most progress in this area. It has developed a RIPK2 kinase inhibitor that is now in phase I trials for inflammatory intestinal diseases (trials began in January 2018).
Over the past few years, Oncodesign has been investing in developing RIPK2 inhibitors produced using its Nanocyclix technology. These are currently in the advanced stages of Lead Optimization.

“Inflammatory diseases such as Crohn’s disease and psoriasis have a massive impact on millions of people worldwide. As a result, they take a heavy social and economic toll on society. That has prompted the pharma industry to show tremendous interest in identifying new therapeutic targets and small molecules treating these diseases. These new small molecules have untapped potential in the treatment of these devastating conditions.”

Dr. Derek Abbott, Professor of Medicine at Case Western Reserve University in Cleveland: