Novartis Goes 2–0 Against J&J in Psoriasis Treatment

Head-to-head study compared Cosentyx and Stelara

Novartis has touted more clinical data showing its blockbuster drug secukinumab (Cosentyx) is better at treating plaque psoriasis than Johnson & Johnson’s rival product ustekinumab (Stelara), according to a BioPharma Dive report. Twelve weeks into the phase 3 CLARITY study, two-thirds of patients taking secukinumab saw the severity of their plaque psoriasis decrease 90%, whereas just under half of patients taking ustekinumab experienced the same amount of skin improvement. Significantly more patients treated with secukinumab also registered as clear or almost clear on the Investigator’s Global Assessment scale, a tool for measuring plaque psoriasis.

Interleukin (IL) inhibitors like secukinumab and ustekinumab have attracted quite a bit of interest from big drug developers over the last decade due to the wide range of diseases they can tackle and the boost they can give bottom lines.

Secukinumab, for example, in its first full year on the market secured two more indications—for ankylosing spondylitis and psoriatic arthritis—and achieved blockbuster status. Ustekinumab has racked up a total of four indications since the FDA initially approved it in 2009, and now brings in around $1 billion per quarter for J&J.

Yet those impressive returns haven’t come without headwinds.

Competition, particularly in the psoriasis setting, has grown stronger. In addition to secukinumab and ustekinumab, the FDA has OK’d Eli Lilly’s Taltz (ixekizumab), Valeant Pharmaceuticals International’s Siliq (brodalumab), and J&J’s Tremfya (guselkumab) for the treatment of plaque psoriasis. Consequentially, the top priority for those drug-makers has become diversifying their products—either through new indications or stronger efficacy profiles.

Novartis has now taken aim at ustekinumab in two late-stage trials. In the earlier CLEAR study, secukinumab significantly outperformed J&J’s drug in the treatment of adults living with moderate-to-severe psoriasis, as measured by both the Psoriasis Area Severity Index and the Dermatology Life Quality Index.

The Swiss pharma is also optimistic that secukinumab’s latest approvals will help it reach $3 billion in annual sales this year. During an investor day in November, Novartis estimated the global market for spondylarthritis, which includes psoriatic arthritis and ankylosing spondylitis patients, was $9 billion in 2016.

To be fair, J&J isn’t sitting idle. While the CLEAR and CLARITY studies put secukinumab above ustekinumab, J&J is looking to prove that its newer IL-23 inhibitor Tremfya is the drug to beat. The big pharma has a phase 3 trial in the works that pits Tremfya head to head against secukinumab (an IL-17A inhibitor) in moderate-to-severe plaque psoriasis. The trial is expected to read out later this year.

Source: BioPharma Dive; January 16, 2018.