MarketVue®: Dupixent-refractory atopic dermatitis (AD)
The MarketVue®: Dupixent-refractory atopic dermatitis market landscape report combines primary (KOL interviews and survey data) and secondary market research to empower strategic decision-making and provide a complete view of the market.Every MarketVue® includes a disease overview, epidemiology (US and EU5), current treatment, unmet needs, pipeline and access and reimbursement chapter.
Topics covered in this report:
• Disease overview: Review the disease pathophysiology and potential druggable targets
• Epidemiology: Understand prevalence, diagnosed and drug-treated prevalence of the population and key market segments
• Current treatment: Understand the treatment decision tree and strengths and weaknesses of current on-label and off-label treatment
• Unmet needs: Identify opportunities to address treatment or disease management gaps
• Pipeline analysis: Compare current and emerging therapy clinical development strategy; their performance on efficacy, safety, and delivery metrics; and their potential to address unmet needs
• Value and access: Review the evidence needed to assess and communicate value to key stakeholders (e.g., providers, payers, regulators) and learn what competitors have done or are doing
Methodology:
Research for the MarketVue®: Dupixent-refractory atopic dermatitis report is supported by 4 qualitative interviews with key opinion leaders (U.S. Dermatologists), a quantitative survey with 27 U.S. physicians and secondary research.
Geographies covered:
United States plus epidemiology for EU5 (France, Germany, Italy, Spain, United Kingdom)
Key companies mentioned:
• Eli Lilly
• Galderma
• Amgen
• Sanofi
• Keymed Biosciences
• Kyowa Kirin
• Ichnos Sciences
• Akesobio Australia
• Jiangsu Hengrui Pharmaceuticals
• Sunshine Guojian Pharmaceutical
• Oneness Biotech Co
• Allakos Therapeutics
Key drugs mentioned:
• Topical corticosteroids
• Dupilumab (Dupixent)
• Abrocitnib (Cibinqo)
• Upadacitinib (Rinvoq)
• Tralokinumab (Adbry)
• Methotrexate
• Cyclosporine
• Azathioprine
• Mycophenolate (Cellcept)
• Ruxolitinib (Jakafi, Jakavi, Opzelura)
• Crisaborole (Eucrisa)
• Lebrikizumab (Ebglyss)
• Nemolizumab (Nemluvio)
• Rocatinlimab
• Amlitelimab
• CM310
• Telazorlimab / ISB 830
• AK120
• SHR-1819
• CM326
• FB825
• Lirentelimab / AK002
Key takeaways from the report:
Atopic dermatitis (AD) is a chronic, inflammatory skin disease characterized by skin lesions and severe itching.
Dermatologists typically begin AD treatment with topical corticosteroids (TCS), then progress to Dupixent for uncontrolled, moderate-severe cases. For patients who are refractory to Dupixent (9% of moderate cases and 16% of severe cases), physicians turn to oral JAK inhibitors despite associated black box warnings, according to REACH Market Research. Adbry, an IL-13 with a similar mechanism of action to Dupixent, was recently approved, however, interviewed dermatologists report that in their experience Adbry is not as effective as Dupixent.
These post-Dupixent AD therapy options include:
• LEO Pharma’s IL-13 inhibitor Adbry (Tralokinumab)
• Pfizer’s JAK inhibitor Cibinqo (Abrocitinib)
• AbbVie’s JAK inhibitor Rinvoq (Upadacitinib)
The AD pipeline is full of promising new biologics in development, including:
• Eli Lilly & Co.’s IL-13 inhibitor – lebrikizumab
• Keymed Biosciences Co. Ltd.’s IL-4Rα inhibitor – CM310
• Galderma’s IL-31R inhibitor – nemolizumab
• Amgen/Kyowa’s OX40 inhibitor – rocatinlimab
Most therapies in development for AD target patients with inadequate response to topicals rather than Dupixent-refractory patients, however, Eli Lilly and Co.’s lebrikizumab is one of the few investigational therapies specifically being studied in Dupixent-refractory patients.
Dermatologist, U.S.: “If a patient had suboptimal response to Dupixent, I would explain that the tralokinumab has a similar mechanism, and people might not be against injection, but it’s not their favorite thing to do, putting all those factors together. Some patients may say, ‘I’d rather try a different medication with a different mechanism,’ and also, you know, it’s a pill. It’s kind of appealing to them, but then others will say, you know, ‘No problem, I’d rather stay with a biologic because that’s what the FDA recommends.’”
Please note: the online download version of this report is for a global site license.
- 1. DISEASE OVERVIEW
- A chronic, inflammatory skin disease characterized by dry, inflamed skin lesions and severe itching
- Table 1.1. Common triggers of AD flares
- Figure 1.1. Disease comorbidities
- Disease mechanism
- Figure 1.2. Pathogenesis of AD
- Figure 1.3. Flare prevalence and impact
- 2. EPIDEMIOLOGY & PATIENT POPULATIONS
- Disease definition
- Figure 2.1. U.S. and EU5 diagnosed prevalent cases of AD by region
- Table 2.1. Prevalent cases of AD in the U.S. and EU5
- Dupixent-treated AD patient population
- Table 2.2. Diagnosed cases of Dupixent-treated AD in the U.S. and EU5
- 3. DIAGNOSIS & CURRENT TREATMENT
- Overview
- Figure 3.1. Dermatologist-reported agreement with the characterization of AD patients who respond poorly/suboptimally to Dupixent or are Dupixent-refractory
- Physicians categorize patients by non-response and suboptimal response after 5-6 months of treatment
- Figure 3.2. AD patients treated with Dupixent, those who are refractory, and those who achieve a sub-optimal response
- Figure 3.3. Dupixent treatment duration before other treatment options are considered
- Treatment algorithm for Dupixent-refractory AD patients
- Figure 3.4. Treatment pathway for Dupixent-refractory AD patients
- Treatment goals for Dupixent-refractory patients don’t change, but the approach does
- Figure 3.5. Treatment goals for Dupixent-refractory AD
- Figure 3.6. Current treatment patient share
- Dermatologists exhaust all treatment options for Dupixent non-responders
- Current Dupixent-refractory AD treatment options are moderately effective but may come with safety concerns
- Table 3.1. Upsides and downsides of current treatments used in Dupixent-refractory AD patients
- Current Dupixent-refractory AD treatment options have their limitations
- Key treatment dynamics that shape disease management and drug use in Dupixent-refractory AD
- Table 3.2. Must-know AD treatment dynamics for now and the future
- Lebrikizumab is likely to be the next approved biologic, but there is competition on the way
- Figure 3.7. Important dynamics of Dupixent-refractory AD market evolution
- 4. UNMET NEED
- Overview
- Figure 4.1. Dermatologist-reported percentage of patients with unsatisfactory outcomes with current treatments post-Dupixent failure
- Figure 4.2. Dermatologist-reported unmet needs in Dupixent-refractory/NR/sub-optimally responsive patients
- Physicians are largely satisfied with available treatment options post-Dupixent failure but unmet needs remain
- Figure 4.3. Top unmet needs
- 5. PIPELINE ANALYSIS
- Overview
- Figure 5.1. Dermatologist-reported most promising mechanisms of action in the pipeline
- Improvement in the extent and severity of skin lesions is the primary goal of emerging therapies
- Table 5.1. Key Phase 3 trials of biologics in development for moderate-to-severe AD
- Biologics and novel mechanisms are the future of AD therapeutics
- Table 5.2. Ongoing key Phase 2 trials of biologics in development for moderate-to-severe AD
- Lebrikizumab is poised to compete for first-line use post-Dupixent failure if approved
- Figure 5.2. Select results from Phase 3 trials of lebrikizumab in moderate-to-severe AD patients (ADvocate1, ADvocate2, and ADhere trials)
- 6. VALUE AND ACCESS
- Overview
- Table 6.1. Current pricing of select systemic AD treatments
- Table 6.2. Typical U.S. commercial payer coverage of post-Dupixent therapies
- Dupixent access and reimbursement dynamics in AD
- Figure 6.1. Dupixent-treated patients by insurance type, U.S.
- Figure 6.2. Reimbursement and access considerations for emerging therapies in refractory AD
- Figure 6.3. Dermatologist-reported percentage of patients who have difficulty accessing and/or staying on Dupixent due to insurance restrictions, high OOP costs, or adverse reactions
- 7. METHODOLOGY
- Primary market research approach
- Epidemiology methodology
- Disease definition
- Diagnosed prevalence estimates
Research Assistance
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