Despite the plethora of drugs currently available for patients with psoriatic arthritis (PsA), several key unmet needs remain, according to GlobalData, a leading data and analytics company.

The company’s report: ‘Psoriatic Arthritis: Global Drug Forecast and Market Analysis to 2028’ reveals that the PsA market was worth over $4.6bn in 2018 and is set to grow to $9.4bn by 2028. Key unmet needs in the disease space include increased clinician awareness, earlier PsA diagnoses, improved drug safety and efficacy across all disease domains as well as improved access to therapies.

In the last several years, the number of available PsA therapies has more than doubled. They span several different mechanisms of action, including csDMARDS, TNF inhibitors, various anti-IL inhibitors, and a variety of small molecule therapeutics. However, Key Opinion Leaders (KOLs) interviewed by GlobalData have noted that delayed referral to rheumatologists still remains one of the biggest hurdles to early intervention in PsA.

Tiffany Chan, Immunology Analyst at GlobalData, explains: “Delayed diagnosis and referrals by PCPs and dermatologists, as well as the logistical limitations in seeing a rheumatologist are to blame for the lag time between onset of symptoms and formal diagnosis. Additionally, PsA is often misdiagnosed due to a lack of a definitive serum test and a heterogeneous clinical presentation that can often mimic other autoimmune conditions. There is currently no cure for PsA, and a portion of patients fail their first-line biologic therapies.”

Due to the heterogeneous presentation, KOLs note that while a drug may work well to address one disease domain, there are still multiple others that it might not adequately address. This need to control joint and skin manifestations is a major hurdle for physicians.

Chan adds: “GlobalData expects that the situation will continue to improve over the next decade, and that PsA will be diagnosed and treated at higher rates over the next ten years. However, interdisciplinary communication between rheumatologists and dermatologists is a key part of early diagnosis. The need of diagnostics, both biomarker and serum tests, to guide treatment plans, is expected to remain unmet.

“Due to the variability of clinical presentation and patient access to expensive biologics, accurate diagnosis and treatment of all PsA patients remains elusive.”