Friday, November 20, 2015

Protein Kinase Inhibitors after the ACR 2015 Meeting in San Francisco – how much Hype is left?

I have already written about hype or hope in protein kinase inhibitors. Now, after the ACR 2015 Annual Meeting in San Francisco it’s time to ask: how much hype is left?

Here a chart, I’ve prepared only a year ago:

Xeljanz (tofacitinib) is on the market in the US for the treatment of rheumatoid arthritis, but still lacks approval in Europe.
Otezla (apremilast) has been approved in the US and later in Europe for the treatment of psoriatic arthritis.
One study on fostamatinib came up, but only on bovine cartilage cells – but still unexpected for me; see: links.
Baricitinib had been discussed in several studies, posters, talks at the meeting; I’ll write on the studies in detail, soon.

Addendum: somehow I've left out filgotinib. Filgotinib is still in the race. Please look for more details under links.

This list above is incomplete, I know, but it shows how many hopes we had. I think that too many pharmaceutical companies tried to run for a small molecule, which is easier to produce, but might be sold at a high price. This mass of different molecules with facets of different effects was fuelling the hype, which peaked, when Xeljanz got the FDA approval.
But I assure you: the hype is gone. Xeljanz is struggling for EMEA approval. Fostamatinib like most others have been abandoned as potential drugs. Otezla is approved in Germany, but will hardly be used because of failure of obtain a positive GBA ruling. The GBA (Federal Joint Committee) “exerts a direct influence on the healthcare provisions”; for further details look at Wikipedia, you can use the link below. And I think that Baricitinib will reach approval, too.

I hope that the pharmaceutical industry is prudent enough not to overprice small molecules, so that our patient's needs are addressed.


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