Oral contraceptives and non-steroidal anti-inflammatory drugs (NSAIDs) remain first-line therapies in the endometriosis market across the seven major markets (7MM*) due to their affordability, side effect profiles and ease of use. However, the treatment algorithm for endometriosis will see significant changes given the promising pipeline, which includes GnRH antagonists, Relugolix and Linzagolix, and a vaginal ring, Quinagolide, according to GlobalData, a leading data and analytics company.

According to GlobalData’s report, ‘Endometriosis – Global Drug Forecast and Market Analysis to 2030’ the endometriosis market has long been dominated by generic and off-label medications, with the launch of AbbVie’s Orilissa (elagolix) in 2018, the first endometriosis-specific therapy in over a decade. However, in an interview with GlobalData, key opinion leaders (KOLs) noted that, despite the novelty of the drug, the US patient uptake was ‘slow and disappointing’.

Sarah Bundra, Pharmaceutical Analyst at GlobalData, comments: “Although the reason for Orilissa’s lack of success is not known, speculations include the drug’s price and physicians’ hesitancy to venture into a new class of endometriosis medications. GlobalData anticipates Orilissa’s sales will be bolstered by the market launches of Relugolix and Linzagolix, which will normalize GnRH antagonist use to treat endometriosis-associated pain.”

Despite anticipated improvements in efficacy and safety with Linzagolix, Relugolix, and Quinagolide, GlobalData highlights several unmet needs in the endometriosis field. One of the most frequently discussed unmet needs among KOLs interviewed by GlobalData across the 7MM is the necessity for greater awareness of endometriosis among both the public and medical professionals.

Bundra continues: “Globally, women experience an average delay of seven to ten years between symptom onset and diagnosis time, by which point the disease may have progressed significantly.”

Additional areas of need include non-invasive diagnostic methods, non-hormonal therapeutics, drugs with long-term safety and efficacy, and closing the gap in understanding of the disease’s etiology and pathophysiology. These are unmet needs that have persisted in this field for years and are needed to produce therapeutics that adequately address patients’ pain over the course of the illness.

Bundra concludes: “Current marketed drugs cannot be used for more than 24 months at a time due to concerns of bone mineral density (BMD) loss. Better understanding of the disease etiology and non-invasive diagnostic procedures will also improve diagnosis delays, which contribute to substantial suffering among endometriosis patients. Additionally, having non-hormonal therapy options for women afflicted with endometriosis is an important area of development so that women can attempt to conceive while also treating their pain.”

*7MM: The US, France, Germany, Italy, Spain, the UK, and Japan