Q&A With David Jimenez, President of Janssen Immunology

David Jimenez

Patients with conditions like psoriasis, I.B.D. and rheumatic diseases can often face struggles finding proper treatment. David Jimenez, president of Janssen Immunology, speaks with Pharmaceutical Executive about his work bringing care to patients from diverse communities.

Pharm Exec: What are the struggles that patients with psoriasis, I.B.D., or rheumatic diseases are facing?

Jimenez: There has been incredible innovation in immunology over the past two decades, much of which Janssen played a lead role in, but needs still remain. Immune-mediated diseases are chronic and often debilitating, with millions in the U.S. going undiagnosed, untreated, or under-treated^1,2,3-not to mention, people of color face additional challenges.

To be specific about the struggles patients face, people who live with these diseases can experience relapses and flares if their disease is not managed effectively.^4,5 Take plaque psoriasis (PsO), for example–there are eight million Americans living with psoriasis.⁶ There have been significant advances in diagnosis and treatment, yet delayed treatment and undertreatment still remain an issue for some. Many patients can benefit from having additional awareness, education, and support mechanisms to inform their treatment decisions.

Studies show that disease prevalence among people who are Black/African American is likely underestimated due to underreporting, delayed diagnosis, or misdiagnosisand Black/African American individuals report greater disease severity.^7,8 Patients identifying as Asian have reported greater disease severity compared to white patients.⁹ These unmet needs are part of a broader problem that extends beyond immunology–the color of one’s skin is a determinant of access to care, quality of care, and health outcomes. It can impact life span and experiences with not only immune-mediated diseases, but many other conditions, such as cancer.

We are committed to relentlessly advancing care to meet these needs and, as part of the Pharmaceutical Companies of Johnson & Johnson, to investing in and promoting health equity solutions that deliver on the Company's Our Race to Health Equity initiative.

Pharm Exec: How has care and treatment for patients with immune-mediated diseases advanced over recent years?

Jimenez: There certainly has been significant progress in immunology over the past several decades.

Patients have more treatment options than ever before. We take pride in knowing Janssen Immunology played an important role, with our commitment leading to a legacy of innovation and industry firsts. We know patients want and need appropriate treatments that meet their needs. Research and development at Janssen Immunology has led to multiple medicines for these patients, including TREMFYA®, the first IL-23 inhibitor approved in the U.S. to treat adults with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy (PsO) and adults with active psoriatic arthritis (PsA).¹ As more treatments have become available, efforts have been made to increase access to new options, too.

There have also been notable advancements in care, including increased awareness of underrecognized symptoms and challenges that may accompany chronic disease. Care is becoming holistic, with a greater focus on well-being.

Looking ahead, what’s exciting is that we are in a promising time as it relates to scientific innovation in immunology. This could mean additional advancements in treatment and care, including the opportunity to maximize the potential of medicines and apply them to many diseases.

Pharm Exec: What are some of the ways that the Pharma industry can improve the patient experience?

Jimenez: We can better address the disparities in care among people of color as mentioned earlier. We know that inequities in care among people of color with immune-mediated diseases can result in missed or delayed diagnoses or in individuals being less likely to receive treatment with advanced therapies.^8,2,3

We have a responsibility to shape a more equitable future. To achieve it, we need to better understand the inequities in order to identify and implement real solutions.

At Janssen Immunology, we are doing our part to put this into action. We recently launched the Determi-Nation initiative, a new kind of health movement comprised of an inspiring and diverse group of healthcare providers, patients, and advocates passionate about advancing health equity.

We are working to ensure people with a variety of lived experiences and diverse identity markers are included in clinical studies, leading to the launch of VISIBLE, a first-of-its-kind, large-scale prospective clinical study in dermatology dedicated to people of color living with moderate to severe plaque and/or scalp psoriasis.⁴ And we’re working to increase representation among specialty providers. We have partnered with the American Academy of Dermatology and Johnson & Johnson Consumer Health to launch Pathways: Inclusivity in Dermatology, aimed at increasing the number of Black, Hispanic and Indigenous physicians in the field.¹

Pharm Exec: What are the most significant changes you’ve seen in the industry over the past 20 years?

Jimenez: The most significant changes I have observed is how companies are focusing on even more individualized patient care. From effectively identifying gaps in care that exist for patients, especially patients of color, to generating inclusive scientific evidence and redefining treatment paradigms, the industry is driving efforts to advance care and truly go beyond the science. We have the opportunity to be more impactful and intentional in how we approach patient care today – delivering innovative solutions in an individualized way–enabled through technology, like AI, to move away from a one-size-fits-all approach.

At Janssen Immunology, we are taking an even more active role in working closely with patients, advocates, and healthcare providers to identify these gaps and arm the community with data, education, and resources to foster more equitable care. Through our Race to Health Equity efforts, such as Determi-Nation, VISIBLE, and Pathways: Inclusivity in Dermatology, we’re focused on going beyond science to help patients in their journey to live unburdened by disease–now and in the future.

Resources

1. Lubrano E, Perrotta FM, Scriffignano S, Coates LC, Helliwell P. Sustained Very Low Disease Activity and Remission in Psoriatic Arthritis Patients. Rheumatol Ther. 2019;6(4):521-528.https://doi.org/10.1007/s40744-019-00171-w
2. Alsoud D, Verstockt B, Fiocchi C, Vermeire S. Breaking the therapeutic ceiling in drug development in ulcerative colitis. Lancet Gastroenterol Hepatol. 2021;6(7):589-595. doi:10.1016/S2468-1253(21)00065-0
3. Crohn's and Colitis Foundation of America . (n.d.). The Facts about Inflammatory Bowel Diseases. THE FACTS ABOUT Inflammatory Bowel Diseases https://www.crohnscolitisfoundation.org/sites/default/files/2019-02/Updated%20IBD%20Factbook.pdf. Accessed July 20, 2022
4. Ghosh S, Mitchell R. Impact of inflammatory bowel disease on quality of life: Results of the European Federation of Crohn's and Ulcerative Colitis Associations (EFCCA) patient survey. J Crohns Colitis. 2007;1(1):10-20. doi:10.1016/j.crohns.2007.06.005
5. Lee S, Mendelsohn A, Sarnes E. The burden of psoriatic arthritis: a literature review from a global health systems perspective. P T. 2010;35(12):680-689.
6. The National Psoriasis Foundation. About Psoriasis. https://www.psoriasis.org/about-psoriasis/. Accessed July 20, 2022
7. The National Psoriasis Foundation. Psoriasis Statistics. https://www.psoriasis.org/psoriasis-statistics/ Accessed July 20, 2022
8. Alexis AF, Blackcloud P. Psoriasis in skin of color: epidemiology, genetics, clinical presentation, and treatment nuances. J Clin Aesthet Dermatol. 2014;7(11):16-24.
9. M. Abrouk et al. Ethnicity affects the presenting severity of psoriasis, Journal of the American Academy of Dermatology, Volume 77, Issue 1, 2017, Pages 180-182, ISSN 0190-9622, https://doi.org/10.1016/j.jaad.2017.02.042.
10. Belasco J, Wei N. Psoriatic Arthritis: What is Happening at the Joint? Rheumatol Ther. 2019 Sep;6(3):305-315. doi: 10.1007/s40744-019-0159-1. Epub 2019 May 17. PMID: 31102105; PMCID: PMC6702660.
11. Aslam T, Mahmood F, Sabanathan A, Waxman R, Helliwell PS. A clinical and radiographic comparison of patients with psoriatic arthritis from different ethnic backgrounds. Rheumatology. 2021 Jan; 60(1):340-345. https://doi.org/10.1093/rheumatology/keaa298.
12. The National Psoriasis Foundation. Treating Skin of Color. https://www.psoriasis.org/advance/treating-skin-of-color/ Last accessed December 3, 2021.
13. Janssen Initiates First-of-its-Kind Clinical Study to Bridge Critical Gaps in Care for People of Color with Moderate to Severe Plaque Psoriasis. Press release. Johnson & Johnson. March 22, 2022. Accessed July 20, 2022. https://www.jnj.com/janssen-initiates-first-of-its-kind-clinical-study-to-bridge-critical-gaps-in-care-for-people-of-color-with-moderate-to-severe-plaque-psoriasis
14. American Academy of Dermatology Association. Pathways: Inclusivity in Dermatology. 2022. https://www.aad.org/member/career/diversity/diversity-pathways. Accessed 20 July 2022