The rheumatoid arthritis (RA) market is expected to grow from $26.2bn in 2019 to $29.1bn in 2029 across the eight major markets (8MM*) at a compound annual growth rate (CAGR) of 1.0%, according to GlobalData, a leading data and analytics company.

The company’s latest report, ‘Rheumatoid Arthritis: Global Drug Forecast and Market Analysis to 2029’, reveals that although the RA market is expected to grow during the forecast period, this growth will be stymied by erosion from biosimilars.

Rose Joachim, PhD, Senior Immunology Analyst at GlobalData, explains: “Between 2019 and 2029, there will be modest growth in the RA market. Growth will mainly be driven by the continued uptake of new marketed products in the Janus kinase (JAK) inhibitor class, as well as the anticipated approval and launch of four pipeline therapies.

“With an expected CAGR of 7.2%, the growth of the JAK inhibitor class will powerfully shape the RA market over the next decade. In particular, AbbVie’s recent global launch of the JAK1 inhibitor, Rinvoq, will significantly expand market share for JAK inhibitors, bringing in $2.2bn in sales by 2029. Gilead/Galapagos’s newly launched JAK1 inhibitor, Jyseleca, will also contribute to growth in this drug class, but to a smaller degree as the agent will not be launched in the US.”

GlobalData’s report highlights four late-stage pipeline therapies for RA. Three are biologics, including Taisho’s tumor necrosis factor inhibitor, ozoralizumab, R-Pharm’s interleukin 6 inhibitor, olokizumab, and GlaxoSmithKline’s granulocyte-macrophage colony-stimulating factor inhibitor, otilimab. The fourth drug, Roche/Genentech’s fenebrutinib, is an oral Bruton’s tyrosine kinase inhibitor. Together, these four pipeline agents are expected to represent less than 5% of the RA market in 2029, equivalent to about $1.1bn.

Joachim continues: “Of these agents, key opinion leaders (KOLs) interviewed by GlobalData were most interested in those with new mechanisms of action (MOAs), namely otilimab and fenebrutinib. However, KOLs did not think that any of the four late-stage pipeline agents would be able to outperform currently marketed biologics and JAK inhibitors. They questioned whether the new MOAs might prove useful in combination regimens, but stressed that this would need to be tested in clinical trials.”

Despite numerous sources of growth and development in the RA market, GlobalData expects market size to be severely impacted by biologic patent expiries, and the subsequent influx of discounted biosimilar products.

Joachim adds: “Between 2019 and 2029, biosimilar sales will increase from 5% to 28% of the global RA market. Due to favorable local regulations and increased access, biosimilar uptake is expected to be the highest in Europe. By 2029, GlobalData projects that biosimilar sales in the 4EU* and the UK will represent nearly half of total RA sales, with 60% coming from sales of adalimumab and etanercept biosimilars.”

Rolling launches of new biosimilars will ratchet up the competition in an already dense, complex market. However, KOLs interviewed by GlobalData have emphasized that despite all the available drugs, there is still room for the standard of care in RA to improve. In particular, they highlighted the need for therapeutic strategies targeting patients with early and preclinical RA, novel pharmaceutical options for treatment-refractory patients, as well as more personalized treatment algorithms for patients with active disease.

*8MM = US, France, Germany, Italy, Spain, the UK, Japan, and Australia; 4EU = France, Germany, Italy, and Spain

Information based on GlobalData’s report: ‘Rheumatoid Arthritis – Global Drug Forecast and Market Analysis to 2029