Eli Lilly versus the 800-pound gorilla in atopic dermatitis? It may just have a shot — at 2nd place
Eli Lilly turned a few heads when the market major bought out the IL-13 lebrikizumab for $1.1 billion a little more than 2 years ago. And late last year it kept up the rah-rah when CEO Dave Ricks tapped this drug as a top-5 drug in the late-stage pipeline.
Could Elli Lilly and European partner Almirall really think they could take on the Il-13/IL-4 Dupixent, the 800-pound biologic gorilla in atopic dermatitis, from Regeneron and Sanofi?
Over the weekend, though, they managed to turn a few more heads with the definitive — and quite positive — Phase III data they’re taking to the FDA. Now the question isn’t can they compete, but is it good enough to change the course of one of the industry’s most successful drug franchises?
We knew the top-line results were positive going into the detailed reveal. But when you are taking on a dominant player in a field, everyone wants to see how it compares to the titleholder. And Jefferies ran those numbers, flagging 2 critical cross-comparisons:
- EASI-75: lebrikizumab 33%-43% vs Dupixent 32%-36%
- IGA 0 or 1: lebrikizumab 22%-30% vs Dupixent 28%
As anticipated, lebrikizumab appears superior when it comes to efficacy treating itch, the key symptom of issue for patients, with 27%-34% improvement notable versus Dupixent 26%-29%, in our view.
Given Dupixent’s market-crushing dominance, comparable data are good data. But Jefferies also notes that one of the key comparisons they were looking eagerly to compare, incidents of conjunctivitis, only came out marginally in lebrikizumab’s favor.
(W)e note the 7%-8% conjunctivitis is higher than we were expecting (2.7% in Phase IIb), and just below the 10% observed with Dupixent monotherapy. Recall, a potential for lower rates of conjunctivitis could have been considered differentiating for lebrikizumab.
And that means that “maintenance data 1H22E will be key to determine potential for more convenient 4-weekly dosing vs Dupixent 2-weekly.”
With biologics tapped to significantly grow market share, they concluded that their current €400m peak sales estimate was holding firm.
Eli Lilly is no little biotech. It is a global powerhouse noted for a series of steps forward — and back. On the other hand, Sanofi plus Regeneron has turned out to be the power player to beat for the biologics share of atopic dermatitis. Both are intensely sales-focused on the marketing side, and Dupixent has now had 5 long years to establish itself with physicians and patients.
Beating Dupixent with these data seems out of the question right now. But the fact that Lilly may just land a blow or two looks like a big win — provided no nasty surprises await between now and a presumed FDA approval.