Welcome to the Autoimmune Drug Development Report

You’re getting this email because at some point you signed up for something I was doing - either the Evidence Based Rheumatology podcast, my newsletter on Figure 1, or the ebrheum.com mailing list. Hoping you will join me on another adventure!

The past decade has been a wild ride for rheumatology. New mechanisms, new targets, new approvals - many of them legitimate breakthroughs. It has also been a decade of spectacular waste: failed trials that were predictable failures, drugs with implausible paths to market, shoddy endpoints and endpoint shenanigans, and of course the ubiquitous prioritization of business major priorities over clinical judgment.

I’ve been complaining about drug development for a long time. This newsletter is going to be an effor to be more proactive. I am planning to center each issue around one of three themes on a quasi-rotating schedule:

1. Pipeline Monitor will cover what’s coming in the next few years, including a “BUY/HOLD/SELL” rating for each.

2. Regulatory Breakdown will cover what just landed - new approvals, label decisions, or major trial results - each rated on a five-star scale for their potential impact (shout out to Anthropocene Reviewed).

3. Critical Commentary will be focused on bigger picture ideas - what keeps going wrong, why it keeps going wrong, and what better drug development in rheumatology would look like.

I’m an Associate Professor of Medicine at the Medical College of Wisconsin, where I’m the Medical Director of the Vasculitis Program, Program Director for Rheumatology, and Associate Program Director for Internal Medicine. Mostly, I’m a rheumatologist who takes care of patients and wishes they had better options.

My primary audience is rheumatologists, but this newsletter is also for anyone who is interested in autoimmune drugs. If you’re in clinical development, you’ll find a clinician’s perspective on what the data actually show. If you’re in medical affairs or commercial strategy, you’ll find honest assessments of where approvals are headed and why some drugs are going to underperform their labels. If you’re an investor in this space, you’ll find some spicy hot takes about whether you’re looking at a genuine blockbuster or yet another also-ran.

The first three issues will be free, covering recent info from each of the major themes. After that, the newsletter runs every other Tuesday. Please signup below!