Recent Chart Audit Reveals Switching Rheumatoid Arthritis Patients to Roche/Genentech's RoActemra (Actemra) is Significantly More Common in the EU5 than it is in the US

EXTON, Pa., Nov. 21, 2017 /PRNewswire/ -- Analysis of over 2,200 RA patients in the US and EU5 (France, Germany, Italy, Spain, and the United Kingdom) reveals clear differentiation in treatment patterns amongst rheumatoid arthritis (RA) patients who have recently switched brands.  US rheumatologists (n=176) report that 28% of their biologic/JAK-treated RA patients switched brands in a given year, a figure significantly higher than the 23% switch rate reported by EU5 rheumatologists (n=243).  Furthermore, US rheumatologists report that significantly more of their RA patients, overall, are treated with biologics than their EU counterparts. While TNF-cycling is still the most predominant switch pattern in both the US and the EU, preference and use of alternate mechanism of action (MOA) biologics/JAKs varies substantially across the geographic locations.

The starkest variances in treatment arise when examining physician preferences for alternate MOA biologics and JAK inhibitors.  Indeed, significantly more EU5 rheumatologists selected RoActemra as their preferred alternate MOA biologic/JAK compared to US rheumatologists.  Top reasons cited in the EU for RoActemra preference include the brand's efficacy, IL-6 inhibiting MOA, and monotherapy use.  Furthermore, the patient audit reveals that switching to an IL-6 inhibitor was significantly more common in the EU compared to the US, with RoActemra accounting for the vast majority of EU IL-6 inhibitor use versus Sanofi/Regeneron's recently approved Kevzara. Conversely, EU5 rheumatologists' stated preference for BMS' Orencia is much less established than in the US; however, in the audit, recent switching to Orencia was slightly more common in the EU5 than in the US.

With EU5 rheumatologists still gaining access and familiarity to JAK inhibitors, it is not surprising US preference for Pfizer's Xeljanz significantly overshadows that of EU5 rheumatologists.  Thus, switching to JAK inhibitors (which have been available in the US for several years in the form of Pfizer's Xeljanz) is significantly more common stateside than in the EU5.  Of note, rheumatologists practicing in Germany have significantly higher rates of switching to the recently approved JAK inhibitors than in the other EU5 countries, many of which are still waiting for market access to Xeljanz and Olumiant. 

Other contrasts in RA switching patterns between the geographic locations involve the reasons and rationale behind recent switches.  While efficacy-related issues are the leading reasons behind switching from a biologic/JAK in both the US and the EU, secondary efficacy failure, or waning efficacy, is more of a driver in the EU, while primary failures, or a lack of initial response, are attributed to a greater percentage of recent US switches. Patient requests also play a less substantial role in the decision to switch in the EU5 than in the US, potentially due to the use of direct to consumer advertising.  Specifically, patient requests were involved in just under one-fifth of the EU5 switches and were the primary driver for only 6%, compared to the US, where patient requests played a more substantial role in driving a switch.

RealWorld Dynamix™: Biologic and JAK Switching in Rheumatoid Arthritis are robust and deep patient chart analyses of 1,002 US  and 1,235 EU5 RA patients who were switched from one biologic or JAK to a different brand in the past three months. RealWorld Dynamix™ captures the clinician's perspective on why the switch was made and the new brand chosen, as well as future intentions should the response be suboptimal. In addition to patient demographics and treatment history, clinical assessments, diagnostic tests and laboratory values are included to provide insight into the clinical course of the disease.

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