Psoriasis Identifying and Commercializing Frontier Pharma

Psoriasis is a chronic, inflammatory disease triggered by deregulated Thymus-derived (T) cells, resulting inflammation and benign hyperplasia of keratinocytes within the skin. Manifestations of affected skin are red, thickened plaques with an overlying silver-white scale, which significantly impairs the patient’s physical and mental wellbeing. The primary cause of psoriasis is unknown, as are the mechanisms that lead to immune cells directing inflammatory responses towards the skin. Within the lucrative autoimmune market, the psoriasis market has grown considerably due to the repositioning of all three marketed Tumor Necrosis Factor (TNF) inhibitors: Humira (adalimumab) and Enbrel (etanercept) which were originally approved for rheumatoid arthritis, and also Remicade (infliximab), the first biologic to be approved for Crohn’s disease, an autoimmune disease which largely affects the gastrointestinal system.

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Table of Contents

1 Table of Contents

1.1 List of Tables

1.2 List of Figures

2 The Case for Innovation

2.1 Growing Opportunities for Biologic Products

2.2 Diversification of Molecular Targets

2.3 Innovative First-in-Class Product Developments Remain Attractive

2.4 Changes in the Clinical and Commercial Environment Will be More Favorable to Products That Target Niche Indications and Patient Populations

2.5 Innovation in Psoriasis

3 Clinical and Commercial Landscape

3.1 Disease Introduction

3.2 Epidemiology

3.3 Etiology

3.3.1 Genetic Predisposition

3.3.2 Environmental Factors

3.4 Pathophysiology

3.4.1 Keratinocytes

3.4.2 Dendritic Cells

3.4.3 T-Cells

3.4.4 Angiogenesis

3.4.5 Growth Factors

3.5 Symptoms and Co-morbidities

3.5.1 Skin Manifestations

3.5.2 Psoriatic Arthritis

3.5.3 Uveitis

3.5.4 Cardiovascular Disease

3.5.5 Psychological Impact

3.6 Diagnosis of Psoriasis

3.6.1 Diagnosis of Psoriatic Arthritis

3.7 Treatment

3.7.1 Pharmacological Therapies

3.7.2 Topical Medications

3.7.3 Systemic Medications

3.7.4 Non-Pharmacological Therapies

3.7.5 Combination and Rotational Therapies

3.8 Overview of Marketed Products for Psoriasis

3.8.1 Oral Non-Biologic DMARDs

3.8.2 Off-Label Non-Biologic DMARDs

3.8.3 Biologics

3.8.4 Comparative Efficacy and Safety of Marketed Products

3.8.5 Unmet Need

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