The Future Of Immunology

 

By focusing on the underlying immune pathways that cause disease

If you have an autoimmune condition, however, that’s not what happens.

Instead, your immune system mistakenly treats your body’s normal tissue as an invader and attacks it, which causes chronic inflammation. Research published in The Lancet in 2023 suggests one in 10 people around the world live with an autoimmune disease, an umbrella term that pertains to over 100 conditions, including well-known ailments like rheumatoid arthritis, psoriasis and ulcerative colitis, as well as many lesser-known ones such as Sjogren’s disease and myasthenia gravis. The impact varies by disease, but patients typically develop symptoms that can be painful and debilitating and take a significant toll on quality of life.

Johnson & Johnson has a long history of innovating to help advance treatments for autoimmune diseases. With the introduction of anti-TNF (or tumor necrosis factor) therapies 25 years ago, the company pioneered a revolution that helped define a new standard of care. Since then, Johnson & Johnson has distinguished itself by consistently redefining that standard of care—focusing on diseases where there remains a significant unmet need.

Patient need is the key. Despite these decades of advancements, fewer than 10% of people with an autoimmune disease are able to reach durable remission even on advanced therapies. Some don’t benefit from current therapies at all, while a sizable subset respond at first, but then ultimately relapse. That’s why scientists at Johnson & Johnson are continuing to develop and refine new options aimed at getting more patients into remission and keeping them there.

Johnson & Johnson’s pathway approach to developing new medicines, in combination with deep knowledge relating to specific diseases, enables the company to impact many diseases with a single therapy.

Take, for example, psoriasis and inflammatory bowel disease (IBD)—two very different conditions. Psoriasis is a chronic inflammatory condition that primarily impacts the skin; in IBD, the inflammation and disease are concentrated in the digestive tract. But scientists know that a specific inflammatory cytokine (protein) called interleukin-23 (IL-23) plays a significant role in both conditions.

“Several of our therapies have shown success in selectively targeting this cytokine, and we have set a high bar of assessing clinical and tissue level remission in our clinical trials,” says Dr. Lee.

“Through this pathway approach, we’re advancing treatments that can help provide meaningful improvements in rates of remission across several disease areas, including psoriasis, psoriatic arthritis and inflammatory bowel disease,” says Candice Long, Worldwide Vice President for the Immunology Therapeutic Area, Johnson & Johnson Innovative Medicine.

“While the currently available biologic drugs that block IL-23 are effective for many patients, fewer than 30% of moderate to severe plaque psoriasis patients who are eligible for these medications opt to take them,” says Dr. Lee.

Why?

“Many aren’t comfortable using a biologic therapy because they dislike injections or have a perceived risk of intravenous and injectable treatments,” says Long. Work is underway to develop treatment options in the convenience of a pill.

The IL-23 pathway is a pathogenic driver in diseases like psoriasis, psoriatic arthritis and IBD. Psoriasis is an immune-mediated disease well known for causing scaly plaques, which can be itchy and painful and also take a major toll on self-esteem and overall quality of life. What’s more, this condition causes inflammation throughout the body, and patients have higher rates of serious medical complications like heart attacks and strokes. A substantial number of psoriasis patients also develop psoriatic arthritis, which causes joint pain and deformities if untreated.

“We are committed to helping redefine the standard of care and address the unmet needs and preferences of many patients living with plaque psoriasis,” explains Long, citing findings that were recently published in The New England Journal of Medicine.

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