A new report by BioTrends has shown that TNF-alpha inhibitors, which currently dominate the treatment market for rheumatoid arthritis, may be at risk of losing patient market share to biologics with alternative mechanisms of action.

According to the 106 respondents surveyed, new biologics with alternative mechanisms of action such as Actemra, Orencia, Rituxan and Remicade are gaining significant market share.

A large unmet need, however, still exists for an efficacious and fast-acting therapy for TNF-refractory patients.

The findings are mainly based on two new TNF-alpha inhibitors – Simponi and Cimzia – launched in the second quarter of 2009.

Simponi has outperformed Cimzia on several performance metrics with respect to perceptions about product performance, physician trial and usage, and aggressiveness of initiation in the RA treatment continuum.

Physicians have also shown positive receptivity to the recent launch of Actemra, a TNF-alpha inhibitor alternative with an entirely novel mechanism of action (interleukin-6 inhibition).

The most established injectable TNF-alpha inhibitors (Enbrel and Humira) both significantly outperform other biologics on key efficacy and safety parameters.