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.

Blueprint Medicines announced this morning that the second part of its study on Ayvakit in non-advanced systemic mastocytosis (SM) — a rare disease in which a type of white blood cells known as mast cells builds up — met all endpoints, but the biopharma left key questions unanswered.

In 212 patients, with 141 in the treatment arm and 71 in the control arm, patients who got Ayvakit saw an average 15.6-point decrease in their symptom scores compared to a 9.2-point decrease in the placebo arm at 24 weeks. In an extension study, those on Ayvakit saw their symptom scores drop by 20.2 points by week 48.