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Novartis' Cosentyx effective in psoriatic arthritis study

Further supports drugs ability to reduce progression of damage to joints

Novartis' recently-approved psoriasis therapy Cosentyx is also an effective treatment for the related condition psoriatic arthritis (PsA), according to new phase III data.

Cosentyx (secukinumab) was the first in the new class of interlukin-17 (IL-17) inhibitors to reach the market after being approved earlier this year, and is also the first to show efficacy in PsA patients in a late-stage trial.

PsA is a painful and debilitating that results in chronic inflammation of the skin and joints which leads to significant disability, poor quality of life and reduced life expectancy. It affects around a third of psoriasis patients but may be undiagnosed in up to a quarter of patients.

The results of the FUTURE 1 study - which have been published in the New England Journal of Medicine (NEJM) - showed that Novartis' drug was able to achieve a rapid improvement in skin and joint symptoms and also reduce the progression in structural damage in joints.

The trial involved patients who had progressed after treatment with standard biologic therapy for PsA, TNF inhibitor drugs, and also those who had not received prior treatment. Overall, the proportion of patients experiencing a 20% improvement in symptoms (ACR 20 response) was around 50% for Cosentyx and 17% for placebo, and prior exposure to TNF-blocking drugs did not affect the outcome.

The improvements with Cosentyx were seen after just a few days' treatment and lasted at least a year, according to the study.

Cosentyx brought in around $30m in the second quarter of the year, ahead of Novartis expectations and with around 80% of sales coming from the US market. The company estimates that it had already captured single-digit market share in the US just a few weeks after launch, with good uptake in other countries such as Germany, Canada and Japan.

Novartis has also completed regulatory filings in the US and Europe for PsA and another chronic inflammatory diseases - ankylosing spondylitis - and has said these indications could be as big as psoriasis in terms of market opportunity.

The company's head of pharma David Epstein said recently that Cosentyx could one day "reach as much as $5bn once we have approvals in these different indications."

Brodalumab tops Stelara

Meanwhile, the same edition of the NEJM has published results of two studies comparing AstraZeneca's IL-17 inhibitor brodalumab to Johnson & Johnson's IL-12 and IL-23 inhibitor Stelara (ustekinumab).

Treatment with brodalumab resulted in significant clinical improvements in patients with moderate to severe psoriasis and was superior to both placebo and ustekinumab, said AZ.

Brodalumab is in a race for second place in the IL-17 inhibitor class with Eli Lilly's ixekizumab, but a recent decision by AZ's programme partner Amgen to hand back rights to the drug because of safety concerns has dented confidence in the project.

AZ has since announced a new partnership with Valeant, which has exclusive development and marketing rights and says it plans to file the drug for approval in the EU and US before the end of 2015.

Article by
Phil Taylor

1st October 2015

From: Research



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