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Do We Really Need Another Injected Rheumatoid Arthritis Drug?

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Johnson & Johnson (NYSE: JNJ  ) and GlaxoSmithKline (NYSE: GSK  ) said yesterday that they're pushing their rheumatoid arthritis drug, sirukumab, into phase 3 trials.

One trial will test sirukumab in patients that have failed an anti-tumor necrosis factor-alpha therapy: Pfizer (NYSE: PFE  ) and Amgen's Enbrel, Abbott Labs' (NYSE: ABT  ) Humira, and J&J's own Remicade. The other trial will test patients potentially earlier in disease progression. They only have to have failed a disease modifying anti-rheumatic drug, which could include methotrexate, which is typically given before the anti-TNF-alpha drugs.

Rheumatoid arthritis is gigantic market, but I wouldn't pencil in blockbuster sales just yet.

Sure, there's no cure for rheumatoid arthritis, and people fail the currently available drugs. But there's a lot of competition out there. And doctors aren't necessarily interested in switching to a new drug from something they have experience with. Bristol-Myers Squibb's Orencia is finally on pace to reach blockbuster status this year -- its seventh year on the market.

The most concerning thing about sirukumab is that it has to be injected. The up-and-coming drugs to treat rheumatoid arthritis will be taken orally. Pfizer's tofacitinib is currently under review at the Food and Drug Administration. Furthermore, both Incyte (Nasdaq: INCY  ) in combination with Eli Lilly, and Rigel with AstraZeneca, also have oral drugs in the works.

This doesn't seem like the best way to spend research and development dollars to me, but it's not like either company is hurting for cash. Sometimes it's worth taking a single to balance out the big swings, like the one J&J took with its Alzheimer's drug.

And who knows, maybe sirukumab will turn out to be a wonder drug, better than anything out there and with fewer side effects. Unfortunately with drug development, the only way to know is to run the clinical trials.

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Fool contributor Brian Orelli holds no position in any company mentioned. Click here to see his holdings and a short bio. The Motley Fool owns shares of Abbott Laboratories and Johnson & Johnson. Motley Fool newsletter services have recommended buying shares of Johnson & Johnson. Motley Fool newsletter services have also recommended creating a diagonal call position in Johnson & Johnson. The Motley Fool has a disclosure policy.
We Fools may not all hold the same opinions, but we all believe that considering a diverse range of insights makes us better investors. Try any of our Foolish newsletter services free for 30 days.

Read/Post Comments (4) | Recommend This Article (2)

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  • Report this Comment On August 25, 2012, at 1:37 PM, SpaceVegetable wrote:

    As an RA sufferer, I welcome any and all new drugs. I just recently had to switch to a 2nd injectable because the first (Enbrel) stopped working. I do agree that oral meds are better. Giving yourself injections, well, really sucks. At least it's better than IV infusions, which are really inconvenient. However, it seems that there's huge variation in how people respond to different drugs, so the more options we have available, the better.

    I've had RA for 30 years, since I was 16 years old. In that time, there's been an explosion of new treatments. People getting RA today are far less likely to get the level of joint damage that I have. Back when I was first diagnosed, the initial treatment was aspirin. 16 aspirins a day, which does one's stomach no favors. Nowadays, they're far more aggressive with treatment and hit it with the "big guns", like methotrexate and these biologics, right away to help minimize joint damage.

    From an investment standpoint, another new injected biologic drug may not become a blockbuster or be viewed as the best way to spend research dollars, but from the patient point of view, I think it's a great idea. Now if only they could come up with longer-lasting joint replacements...

  • Report this Comment On August 26, 2012, at 6:40 PM, lglavish wrote:

    I also have RA and agree with the first comment. I was diagnosed less than 3 years ago and am already on my second biologic. There are only 9 currently available and 5 of those are in the same class (anti tnf). My first biologic lasted a year. I'm at just over a year with my second. When the drug I'm on fails I'll probably go to a third anti tnf then be moved out of that class.

    Do the math, many patients burn through these drugs in less than 10 years. If the author spent even one day with the pain of severe, uncontrolled RA he would understand the need for new drugs, injectable and oral.

  • Report this Comment On August 27, 2012, at 2:41 PM, trinaunz wrote:

    Yes, this drug is needed, because it targets an entirely different protein than all but one (Actemra) of the RA drugs currently available. All biologics besides Actemra are designed to inhibit the overproduction of TNF proteins, but sirukumab targets IL-6 proteins instead.

    As an RA patient with way more IL-6 inflammation markers than TNF ones, I welcome an alternative to Actemra, and so will others who may have reactions to Actemra or for whom the Actemra stops working.

  • Report this Comment On September 07, 2012, at 3:45 PM, hiddenflem wrote:

    Brian, after a couple of years of trying most existing RA drugs, my wife is now on Humira. If that doesn't work I am not sure what we will do. Do we need another injected drug--from my own personal perspective, heck yes!

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