Osteoarthritis (OA) is a degenerative joint disease that affects millions of people worldwide and is the most common form of arthritis. It is caused by deterioration of the protective cartilage layer that connects the ends of the bones, and most commonly impacts the hands, hips and knees. OA is more frequently seen in people older than 50 years of age, but younger people can also develop it due to injuries, abnormal joint structure or genetic background.

Despite Zilretta’s (triamcinolone acetonide extended-release) and Joycle’s (diclofenac etalhyaluronate) launches in 2017 and last year, respectively, their addition has not provided a novel approach to the management of OA. GlobalData has identified candidates in the late-stage pipeline that have the potential to shift the competitive landscape and treatment paradigm by addressing important unmet needs over the following decade.

There are currently 120 pipeline products within the seven major markets (7MM: the US, France, Germany, Italy, Spain, UK and Japan). Of these, eight are expected to launch over the next decade (Phases IIb–III). Therapies targeting OA treatment are distinguished into two categories: pain management medications and disease-modifying osteoarthritis drugs (DMOADs). To date, treatments approved or recommended for OA treatment only include pain management regimens that aim to relieve symptoms without stopping disease progression. Drugs currently in the pipeline, however, are targeting both strategies, with a quarter of the late-stage products being DMOADs.

Even though OA is among the most prevalent diseases worldwide, basic unmet needs such as lack of early diagnosis and inability to halt disease progression have yet to be addressed. According to key opinion leaders (KOLs), a significant number of OA patients seek treatment after experiencing pain for months or even years. Lack of knowledge prevents patients from recognising OA-specific symptoms early, which eventually leads to chronic pain and compromises quality of life. In addition, as current OA treatments only target pain and do not prevent disease progression, DMOADs are medications highly anticipated both by physicians and patients.

Two DMOADs currently in the third phase of clinical studies, namely Kolon TissueGene’s Invossa (NCT03203330, NCT03291470) and Biosplice Therapeutics’ lorecivivint (NCT03928184, NCT04385303), are being studied in moderate-to-severe patients and are competing for first-to-market advantage. KOLs interviewed by GlobalData expect that should they make it to market, physicians will swiftly adopt DMOADs in their treatment paradigm and patients will more actively seek treatment for OA, being hopeful that these treatments will effectively prevent disease progression.

OA impacts a large percentage of the population, meaning there is ample opportunity for developers to enter the OA space to address the lack of DMOADs in the market. Developers are striving to be first to market to treat this debilitating joint disease, which has a significant impact on patient quality of life. The first DMOAD to market is likely to grasp a significant market share from current pain management treatments. GlobalData expects the launch of these therapies to shape the OA market and mark a new chapter in the management of OA.

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