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AbbVie lauds head-to-head win for Skyrizi versus Cosentyx

Outperformed rival across all primary and secondary endpoints


It looks like AbbVie has the trial win it was hoping for to unlock the psoriasis market for its recently-approved psoriasis therapy Skyrizi.

The head-to-head study pitted IL-23 antagonist Skyrizi (risankizumab) against Novartis’ blockbuster IL-17 inhibitor Cosentyx (secukinumab) – which has sales currently running at around $1bn a quarter – and according to AbbVie outperformed its rival across all the trial’s primary and secondary outcome measures.

The trial involved 327 patients with moderate-to-severe plaque psoriasis who were randomised to treatment with either Skyrizi or Cosentyx, who were followed up over the course of a year.

At the end of that period, 87% of patients taking AbbVie’s drug had skin that was 90% clear or better – known as a PASI 90 score – compared to 57% of the Cosentyx group. Skyrizi also met a non-inferiority endpoint at 16 weeks, with 74% of patients achieving PASI 90 versus 66% for Cosentyx.

On paper Skyrizi is actually a closer competitor to Johnson & Johnson's Tremfya (guselkumab), which also targets IL-23, but there’s little doubt that – sales-wise at least – Cosentyx is currently its main rival in the plaque psoriasis category.

Tremfya, which made $742m for J&J in the first nine months of 2019, also outperformed Cosentyx in the head-to-head ECLIPSE trial reported in late 2018. It is administered every six weeks, while Cosentyx is given once a month. Skyrizi meanwhile only needs to be dosed every 12 weeks after an initial loading phase.

AbbVie’s drug is still the new kid on the block, having been approved by the FDA for adults with moderate-to-severe plaque psoriasis last April, but has already started to gather some sales momentum.

The company booked $91m in third-quarter 2019 sales for the drug – mostly from the US – and it now expects full-year sales to be around $275m.

Cosentyx, Skyrizi and Tremfya face increasing competition in the psoriasis market however, with a host of other new entrants including Eli Lilly’s Taltz (ixekizumab), Leo/Valeant’s Siliq (brodalumab) and Sun Pharmaceutical’s Ilumya (tildrakizumab) in recent years.

AbbVie has been trumpeting the drug as a best-in-class therapy, pointing to long-term data showing that after two and a half years on treatment, 61% of patients on Skyrizi achieved PASI 100 or complete skin clearance.

It also has registration trials for Skyrizi ongoing in Crohn's disease and ulcerative colitis due to generate results next year, as well as studies in psoriatic arthritis and atopic dermatitis which if positive could allow AbbVie to encroach further into Cosentyx’ territory.

Novartis’ drug is currently approved for adults with moderate-to-severe plaque psoriasis, active psoriatic arthritis and active ankylosing spondylitis.

Article by
Phil Taylor

15th January 2020

From: Research



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