The document discusses the challenges in rheumatoid arthritis (RA) clinical trials, including recruitment difficulties and data quality issues. Covance positions itself as a solution provider by highlighting its extensive experience and resources in conducting RA studies, including patient recruitment and retention strategies. The industry landscape is evolving with increasing biosimilar availability and a focus on early diagnosis and treatment, although unmet needs in RA treatment remain significant.

1. RHEUMATOID ARTHRITIS
TREATMENT LANDSCAPE
Overcome Your Pain Points with an
Experienced and Trusted Partner
RA Drug Development Pain Points
▶ Crowded trial environment causes competition for sites, longer recruitment windows and difficulty in identifying
investigators and locating patients
▶ Only 10% of RA patients participate in clinical trials
▶ Difficulty maintaining data quality due to eligibility creep and subjective trial endpoints
▶ Suboptimal patient retention over long trial periods
▶ Competitive biologics marketplace
▶ Increases in trial complexity exacerbates recruitment and retention challenges
Covance Is Experienced in Overcoming RA Clinical Trial Challenges
▶ 1,200 experienced RA staff including 558 clinical research associates and 148 project managers
▶ Conducted over 41 RA studies involving 10,740 patients across 1,761 sites globally in the past five years
▶ Conducted over 200 pediatric autoimmune and/or inflammatory studies across key therapeutic areas in the last five years
▶ Supported the development of 14 orphan drug approvals granted by the FDA for the treatment of rare rheumatologic disorders,
including juvenile idiopathic arthritis, uveitis, anti-neutrophil cytoplasmic antibody-associated vasculitis, and xerostomia and
keratoconjunctivitis sicca in Sjögren’s syndrome
▶ Helped develop ­14 of the ­15 top IMID drugs, of which a number are indicated in rheumatic conditions
There Remains Significant Unmet Need in RA
Biologic administration
is often inconvenient
and expensive
Safety of RA treatments,
particularly immunosuppressive
drugs, is still a concern
There is
no cure
RA Industry Updates
Increasing availability of biosimilars making biologic treatments more accessible
Biosimilars to infliximab, etanercept and adalimumab all approved
A trend toward more aggressive treatment under the
treat to target strategy
Steady market growth
due in part to aging
population
Movement toward
early diagnosis
and treatment of patients
Expanded range of treatment
options including novel biologics
and small molecules
There Remains Significant Unmet Needs in RA:
▶ There is no cure
▶ Biologic administration is often inconvenientand expensive
▶ Safety of RA treatments, particularly immunosuppressive drugs, is still a concern

2. Addressing the Pain Points of RA Drug Development
Target Patient Populations for Efficient Recruitment
▶ Reduce screen failure rate using Xcellerate®
Trial Design to understand impact of inclusion
criteria on size of eligible patient population
▶ Performance metrics on over 1,600 Phase II-III RA investigators since 2014
▶ Over 250,000 LabCorp RA patients of which 3,200 have agreed to be contacted directly about
relevant clinical trials (September 2019)
▶ All RA study recruitment timelines achieved since 2012
▶ Specialty inflammatory biomarkers, e.g., GlycA, rheumatoid factor and hCRP
Improve Patient Retention Through Education
and Support
▶ Established patient support system, including health education and appointment reminders
▶ Covance voice of patient insights used in trial design to ensurecompliance and retention
U ata
30 billion test
results, 5,000
diagnostic assays
including genotyping,
test results and
diagnoses data
One of the largest
sources of actual patient
data in the world
Direct access to 150
million LabCorp
Patients
400,000 patients
consented to allow
Covance to contact them
Global Trial
Performance Data
50% of all Global
Clinical Trials
16K protocols
200K Investigators
Enabled by Covance
Central Laboratory
Services and Covance
Combined Operational
Experience
Covance
Performance
Database
LabCorp
Data
Full Trial
Planning and
Conduct
Optimization
Harnessing the Best of Both to Drive
Value in Trial Planning and Execution
US Data
30 billion test results,
5,000 diagnostic
assays including
genotyping, test results
and diagnoses data
One of the largest
sources of actual
patient data in the world
Direct access to
150 million
LabCorp Patients
400,000 patients
consented to allow
Covance to contact them
LabCorp Covance: Two Primary Data Sources Provide
Actionable Insights
Covance is the drug, medical device and diagnostics business segment of LabCorp, a leading
global life sciences company. COVANCE is a registered trademark and the marketing name
for Covance Inc. and its subsidiaries around the world.
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Learn more about our drug development solutions at www.covance.com