Overdrive Podcast: Unmet Patient Needs in Rheumatic Disease

Soumya Chakravarty, MD, PhD, discusses the unmet patient needs in immune-mediated diseases as well as Janssen’s work in scientific innovation that allows patients to live their lives more unburdened by their disease. Chakravarty is the Sr Director and Strategic Lead in the Rheumatology Therapeutics area at Janssen.

Below is a preview of our conversation:

Rheumatology Network: Why do you believe fewer than 10% of patients achieved sustained clinical remission?

Soumya Chakravarty, MD, PhD: The ultimate goal of all of our diseases that we have in rheumatology, such as rheumatoid arthritis or psoriatic arthritis, is trying to achieve sustained clinical remission. So being able to live without symptoms, and, as you just noted, few patients are currently, with these most common kinds of diseases, achieving that. So why is that? There are a number of factors that underpin these low numbers. First of all, this is a journey for a lot of patients living with rheumatic diseases, in terms of long treatment times, living further years with their disease before actually getting an accurate diagnosis, as well as the appropriate treatment. Secondly, there's also the issue that once the patient actually receives an accurate diagnosis, that can actually take a little bit more time before an appropriate therapy is initiated. And even with the initiation of therapy, in terms of that prescription being written, there may be additional steps with respect to the fulfillment process. This can be lengthy and complicated. There's a journey here for patients as they try to navigate this system before starting on therapy. So, at the end of the day, I think it's very important for us as Janssen to be able to understand, appreciate these factors, and then be able to move forward with addressing them. And so, our ultimate goal here at Janssen, is for those patients to be able to change sustained clinical remission. And the way to really do that is to invest in research. And our R&D pipeline reflects that in terms of our next era of treatments. But it's not only the research; it's not only having a very robust pipeline and working with our R&D colleagues, but it's also innovating and collaborating with all of the different external stakeholders that are out there, be it advocacy groups, academia, private practices, or governmental organizations to be able to ensure that all of those connections that we've talked about along the journey for these patients are being made. And that there's obviously a commitment to ensuring that patients are getting the therapy that they need at the right time. And that treatment choice and shared decision making is being implemented across the board. So hopefully, that gives a little bit of an overview of where we think, at Janssen, we're going on this question of trying to attain remission for our patients.

RN: What are some of the unmet needs and immune mediated diseases?

SC: There’s a tremendous amount of unmet need for patients with rheumatic diseases, despite all of the advances that we've had right in terms of all of the therapies, such as biologics, targets, synthetic disease-modifying antirheumatic drugs (DMARDs), etc, partly to delay in diagnosis and treatment. So that's just what we touched upon as one of the reasons why many of our patients are still not achieving clinical remission. And I think the challenge here is that these diseases that we encounter are chronic illnesses. These are conditions that patients have to live with, have to manage, and have to navigate this journey for many, many years. So that means it can be very debilitating. There can be a lot of challenges with respect to pain and fatigue that come with moderate-to-severe disease that the patients are suffering from. Of course, there's a disruption in quality of life a potentially increased use healthcare resources, and increased cost. And I think the other issue that we have to acknowledge and address is that patients with rheumatic diseases can wax and wane in terms of their disease course. So, not only is it a very long journey that these patients have to experience, but that they can have periods of time when their symptoms flare. That can manifest itself as swollen tender joints, more stiffness, etc. And if their disease is not effectively managed, an issue we have to all be cognizant of is that there could be these recurring painful relapses. This sums up where the unmet needs and some of the challenges remain.