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Global Axial Spondyloarthritis Treatment Market $5.9 Billion by 2027

The global market for axial spondyloarthritis treatment expected to reach $5.9 billion by 2027, growing steadily at a CAGR of 3.1% over the forecast period, driven by increasing prevalence of axial spondyloarthritis, rapid uptake of premium-priced interleukin inhibitors, and expected launch of promising pipeline therapies.

  • Other factors contributing to market growth include key unmet needs and availability new treatment options against the existing anti-TNFs.
Global Axial Spondyloarthritis Treatment Market

Axial spondyloarthritis (axSpA) is an immune-mediated rheumatic disease that primarily affects the spine and sacroiliac joints, leading to back pain and stiffness. AxSpA consists of 2 subsets of patients: those with non-radiographic axial spondyloarthritis (nr-axSpA) and those with ankylosing spondylitis (AS), also known as radiographic axSpA.

  • The most known member of the axial spondyloarthritis disease family is ankylosing spondylitis. The nr-axSpA is clinically defined by the absence of definitive x-ray evidence of structural damage to the sacroiliac (SI) joint.
    • The results from current studies indicate that approximately half of all patients with axSpA are patients with nr-axSpA. Patients with AS are more likely to be male, whereas nr-axSpA is equally prevalent in both sexes.

The advent of advanced imaging with MRI scanning and the employment of genetic testing for human leukocyte antigen-B27 (HLA-B27) have contributed to the recognition of nr-axSpA in its earlier stages.

  • Approximately 1.5 million Americans are affected by axSpA, with estimates of axSpA’s prevalence ranging from 0.9% to 1.4%. Typically, axSpA affects the younger SpA patient population, with an average age of symptom onset of 28 years.
    • Approximately 60% to 70% of patients with AS develop irreversible structural changes that result in spinal fusion and reduced spinal mobility.
      • Patients with axSpA show an increased prevalence of comorbidities and extraspinal manifestations of the disease, driving axSpA-associated healthcare costs.

Despite an increased understanding of axSpA, unmet needs remain: most essentially, to improve the lengthy time to diagnosis after the onset of symptoms and to appropriate treatment. Prevention of inflammation is key in the management of axial spondyloarthritis.

  • The nonsteroidal anti-inflammatory drugs (NSAIDs) with physical therapy and exercise are strongly recommended as first-line management strategies for patients with active axSpA.
  • The treatment landscape of axSpA has been dominated by anti-TNF agents since the last decade.
    • The TNFα inhibitors are recommended over interleukin (IL)-17A inhibitors as the first biologic treatment. The anti-TNF agents are approved for treatment of radiographic axSpA in the United States and Europe.
  • However, the discovery of the IL-23/IL-17 pathway in 2005, revealed new treatment targets along with molecules and signaling pathways that proved pivotal in the pathophysiology of not only axSpA, but psoriasis and psoriatic arthritis as well.
  • On the other hand, the disease modifying anti-rheumatic drugs (DMARDs) are not very effective for the treatment of axial spondyloarthritis disease.
  • Currently a few agents that inhibit IL-17 or TNF are approved, but several agents with novel modes of action are under investigation. Despite the greater treatment options for patients with axSpA, several challenges remain.
    • First, the efficacy observed with the IL-17 blockade is of similar magnitude to that observed with anti-TNF agents.
    • Second, in spite of this degree of comparable efficacy among the therapeutic agents, about half the patients in clinical trials do not see a significant difference in primary outcomes.
    • Third, oral options are not yet available, and
    • Lastly, high cost and difficulty with access to modern treatment regimens remain a challenging barrier for many patients.

The global market for axial spondyloarthritis drugs research report provides market size ($million 2017 to 2027), market share analysis, growth trends and forecast (CAGR%, 2021 to 2027).

The global market for axial spondyloarthritis treatment segmented by drug class (product/brand) – tumor necrosis factor inhibitors [Humira (adalimumab), Enbrel or Benepali (etanercept), Remicade (infliximab), Cimzia (certolizumab pegol), Simponi Aria (golimumab)], interleukin-17A inhibitors [Cosentyx (secukinumab), Taltz (ixekizumab)], conventional disease-modifying antirheumatic drugs [Trexall, Otrexup, Rasuvo (methotrexate), Azulfidine (sulfasalazine)], pipeline analysis, and geography.

  • Based on the drug classes, the tumor necrosis factor (TNF-alpha) inhibitors segment accounted for the largest revenue share of the total axial spondyloarthritis drugs market.
    • The anti-TNF drugs segment to remain the mainstay treatment for patients with persistently high disease activity. Humira and Enbrel are forecast to retain their position as the preferred first-line biologics in axSpA.
      • However, during the next few years, the anti-TNFs segment expected to grow moderately as result of entry of biosimilars for the key marketed biologics: Enbrel (etanercept), Humira (adalimumab), and Remicade (infliximab), and lower cost of these drugs.
  • On the other hand, the interleukin-17A inhibitors segment anticipated to witness a strong double-digit growth rate throughout the forecast period.
    • Novartis’s first-to-market IL-17A inhibitor, Cosentyx (secukinumab) forecast to register strong uptake and growth rate owing to increasingly supported by positive long-term data.
      • Similarly, Eli Lilly’s IL-17A inhibitor, Taltz (ixekizumab) anticipated to further contribute to market expansion over the forecast period.
  • The conventional disease-modifying antirheumatic drugs (cDMARDs) segment continue to dominate the first-line therapy due to their lower cost, despite lack of evidence for efficacy in axSpA and absence from the treatment guidelines.  

The global market for axial spondyloarthritis drugs research report is further segmented by geography into North America (U.S., Canada), Europe (U.K., Germany, France, Italy, Spain, Rest of EU), Asia Pacific (Japan, China, India, Rest of APAC), Latin America (Brazil, Mexico, Rest of LA), and Rest of the World.

  • In terms of geographical distribution, the North America (particularly the US) region significantly dominated the global axSpA treatment market, followed by the Europe region, attributed to increasing prevalence of axial spondyloarthritis, high-cost of branded drugs in the US as well as the increasing uptake of high-cost interleukin (IL)-17A inhibitors.
    • As compared the US, the five major European markets estimated to register faster decline in sales revenue in the coming years, despite the increasing prevalence of axial spondyloarthritis patients and the increasing penetration of premium-priced interleukin-17A inhibitors.

In addition, the global market for axial spondyloarthritis treatment report provides the detailed market landscape (market drivers, restraints, opportunities), market attractiveness analysis, and market profitability analysis by key products and regions or countries. The report also tracks the major competitors operating in the global market by company overview, financial snapshot, major products, technologies, services offered and recent developments.

Major competitors operating in the global market for axial spondyloarthritis drugs and profiled in this report include AbbVie, Inc., Amgen, Inc., Astellas Pharma, Inc., Eisai Co., Ltd., Eli Lilly and Company, Johnson & Johnson, Merck & Co., Inc., Mitsubishi Tanabe Pharma Corporation, Novartis AG, Pfizer, Inc., Takeda Pharmaceutical Co., Ltd., Torii Pharmaceutical Co., Ltd., and UCB (Union Chimique Belge).

  • Drug Class (Product/Brand)
    • Tumor Necrosis Factor (TNF) Inhibitors
      • Humira (adalimumab)
      • Enbrel or Benepali (etanercept)
      • Remicade (infliximab)
      • Cimzia (certolizumab pegol)
      • Simponi Aria (golimumab)
    • Interleukin (IL)-17A Inhibitors
      • Cosentyx (secukinumab)
      • Taltz (ixekizumab)
    • Conventional Disease-Modifying Antirheumatic Drugs (cDMARDs)
      • Trexall, Otrexup, Rasuvo (methotrexate)
      • Azulfidine (sulfasalazine)
  • Pipeline Analysis
  • Geography
    • North America (U.S., Canada)
    • Europe (U.K., Germany, France, Italy, Spain, Rest of EU)
    • Asia Pacific (Japan, China, India, Rest of APAC)
    • Latin America (Brazil, Mexico, Rest of LA)
    • Rest of the World
  • Company Profiles
    • AbbVie, Inc.
    • Amgen, Inc.
    • Astellas Pharma, Inc.
    • Eisai Co., Ltd.
    • Eli Lilly and Company
    • Johnson & Johnson
    • Merck & Co., Inc.
    • Mitsubishi Tanabe Pharma Corporation
    • Novartis AG
    • Pfizer, Inc.
    • Takeda Pharmaceutical Co., Ltd.
    • Torii Pharmaceutical Co., Ltd.
    • UCB (Union Chimique Belge)

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