AbbVie's Skyrizi hangs Novartis' Cosentyx out to dry in head-to-head psoriasis study
Skyrizi, a key drug in AbbVie’s post-Humira future, has added another feather to its cap.
On Tuesday, the IL-23 inhibitor emerged superior in a head-to-head 327-patient trial against Novartis’ dominant Cosentyx in patients with moderate-to-severe plaque psoriasis.
Data showed Skyrizi induced significantly higher rates of skin clearance compared to Cosentyx, meeting the primary goal of superiority with at least a 90% improvement from baseline in the Psoriasis Area and Severity Index (PASI 90) at week 52. Overall, 87% of Skyrizi-treated patients hit PASI 90, versus 57% of Cosentyx-treated patients at the one year mark.
The other main goal of non-inferiority at week 16 — 74% of Skyrizi patients achieved PASI 90 compared to 66% of Cosentyx patients — was also met. Skyrizi also eclipsed Cosentyx on all secondary endpoints, including PASI 100, and PASI 75.
In the fall of 2017, Skyrizi was evaluated against J&J’s Stelara and its own Humira in a psoriasis study — and emerged victorious, handsomely outpacing the rival drugs in clearing psoriasis.
These head-to-head studies are key to establishing Skyrizi’s position in a crowded market, which includes Humira, Novartis’ anti-IL17 Cosentyx, J&J’s anti-IL23 Tremfya, anti-IL12/23 Stelara, as well as Lilly’s anti-IL17 Taltz.
Skyrizi is not the first pure IL-23 inhibitor to be approved — Tremfya was approved in 2017 and Ilumya in 2018. But the AbbVie drug has a dosing advantage over Tremfya — it is administered every 12 weeks, versus once every two months for Tremfya, SVB Leerink’s Geoffrey Porges said on Wednesday, noting that other psoriasis biologics in addition to the oral Otezla generated a combined $11.1 billion in 2018 sales.
“This does not include sales of anti-TNFs in psoriasis, which should decrease as patients move to these new, more efficacious therapies. These products also all achieved $500 million – $1 billion in the second year of launch, which is likely to also be achieved by Skyrizi,” SVB Leerink’s Geoffrey Porges wrote in a note last year.
“Overall biologics are still used in only 30% of the moderate to severe psoriasis population, (per JNJ in 2017), and AbbVie’s Skyrizi should benefit from both best-in-category efficacy (i.e. market share gains) and the continued rapid market expansion.”
Skyrizi was approved in April 2019. AbbVie paid Boehringer Ingelheim $595 million upfront to license rights to the drug, known chemically as risankizumab, in early 2016. Evaluate has pegged Skyrizi as the number 3 blockbuster on its list of heavyweight drugs launched in 2019, estimating the drug could earn more than $2 billion in 2024 — a far cry from AbbVie’s homegrown estimate of $4 billion to $5 billion in peak sales. Porges has forecast adjusted peak annual sales of $3 billion.
Last August, Lilly’s Taltz beat J&J’s Tremfya in a head-to-head psoriasis study. In 2018, J&J ran its own head-to-head psoriasis trial against Cosentyx — and came out with data that showed Tremfya superseded Novartis’ dominant rival.
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