Reports on MS Treatment Market Show Growing Shift to Oral Therapies

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by Patricia Silva, PhD |

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The multiple sclerosis (MS) market shifted during 2016, with oral disease-modifying therapies (DMTs) capturing a greater share and Sanofi-Genzyme’s Aubagio (teriflunomide) being poised for growth, according to a press release from Spherix Global Insights.

The conclusions were included in the company’s “RealTime Dynamix: Multiple Sclerosis,” a quarterly report based on responses from more than 100 neurologists actively treating MS patients.

According to the report, oral DMTs secured a significantly greater share of the MS market by the end of 2016 than in 2015, with Biogen’s Tecfidera (dimethyl fumarate) leading the way. But forecasts are favorable for Aubagio, a pyrimidine synthesis inhibitor approved for use by the U.S. Food and Drug Administration (FDA). It is designed to reduce MS flares by preventing specific immune cells from functioning.

Teva’s Copaxone (glatiramer acetate) is still leading among injectable drugs, the report said, but it is facing competition from Sandoz’s Glatopa (glatiramer acetate) — the first generic DMT to enter the MS market.

The neurologists said Copaxone use has declined in the past three months as Glatopa’s user base has expanded, but according to the report, some patients and physicians are reluctant to try the generic. Doctors are more willing to prescribe Glatopa for patients new to DMTs than to switch from Copaxone or other agents, the report said.

These conclusions were confirmed in “RealWorld Dynamix: DMT New Starts in Multiple Sclerosis,” a chart audit involving clinical records of 1,027 MS patients who recently switched DMT brands. Analyses of these records, submitted by 242 neurologists, detail why neurologists choose specific DMTs as first-line therapy, and include drug efficacy and safety, and patient request.

“RealWorld Dynamix” also examines each drug brand’s competitive position. The analysis showed that if Copaxone had not been available, a third of the patients would have been started on an oral agent.

The two reports also note increasing comfort with earlier use of high efficacy DMTs in patients with more aggressive forms of MS. The trend is likely to be further fueled if Roche’s Ocrevus (ocrelizumab) receives FDA approval, “RealTime Dynamix” said.

According to a previous story, a sizable number of U.S. neurologists plan to prescribe Ocrevus, and they see a role for it in relapsing MS (RMS) patients. It could challenge infusion treatments such as Biogen’s Tysabri (natalizumab) or Sanofi/Genzyme’s Lemtrada (alemtuzumab), the article reported.

Considering the unmet need in primary progressive MS and the number of RRMS patients not achieving optimal results, “RealTime Dynamix” said that Ocrevus, if cleared for marketing, could be a “disruptive force in the MS space in 2017.”

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