In the race to market the first oral drug to compete with high-priced injectables for rheumatoid arthritis (RA), Pfizer's tasocitinib has the home-stretch lead over Rigel, Vertex, and Incyte. All four contenders are Janus-associated kinase (JAK) inhibitors,
a new class of molecules with anti-inflammatory activity that puts the brakes on RA's joint destruction. In a 600-patient
Phase III trial, Pfizer's twice-daily anti-JAK pill reached two of three of its goals, reducing symptoms and increasing functionality,
but failing to best placebo in number of remissions. Three out of four patients saw a decrease in pain and inflammation. However,
the drug raised the levels of both good and bad cholesterol, a regulatory red flag, especially for drugs used long term by
elderly patients. As a first-to-market RA pill, tasocitinib could garner $2 billion annually in sales, says Sanford C. Bernstein
& Co's Tim Anderson.