August 31, 2023
With Little Remaining Unmet Need for Injectable Biologics for the Treatment of Plaque Psoriasis, US Dermatologists Report the Future is Oral, According to Spherix Global Insights
Despite the increased efficacy of BMS’ Sotyktu over Amgen’s Otezla, dermatologists continue to express a desire for additional oral agents that bring enhanced safety and efficacy.
Exton, PA August 31, 2023 – The biologic treatment armamentarium for plaque psoriasis has arguably experienced some of the most successful developments in recent autoimmune history. With the entry of each next generation biologic, the standards of care and expected bar of performance have continually expanded. Unlike other large immunology markets where the tried-and-true tumor necrosis factor (TNF) inhibitors – Amgen’s Enbrel, Janssen’s Remicade, and AbbVie’s Humira (and now a multitude of biosimilars), are still the initial go-to treatments, biologic advancements in psoriasis have brought increasingly selective and targeted options, improving efficacy, safety, and ultimately convenience. Market entrants such as Janssen’s Stelara, the IL-17 class (specifically Novartis’ Cosentyx, Eli Lilly’s Taltz and Ortho Dermatologics’s Siliq), and most recently, the IL-23’s (Janssen’s Tremfya, Sun Pharma’s Ilumya, and AbbVie’s Skyrizi) have each revolutionized the treatment landscape, making material impacts on overall efficacy and the possibility of total skin clearance a reality for many psoriasis patients.
Despite these biological advancements, there are other medications for the treatment of moderate to severe psoriasis that still hold a substantial role —the currently approved oral small molecules. Amgen’s Otezla (previously Celgene’s) held the limelight as the first and only approved oral agent for these patients since 2014, providing an option for patients who are needle-phobic or desire the convenience of a pill. Despite the favorable administration, US dermatologists consistently report that the brand does not perform to the high standards set by the more recent IL-17 and IL-23 options, and thus Otezla has historically and continues to primarily be used in the pre-biologic setting, prior to initiating patients on an injectable biologic.
Just last year BMS’ Sotyktu, a TKY2 inhibitor, joined Otezla as another oral option. The brand brings a unique mechanism to the market and boasts increased efficacy over Otezla as illustrated in BMS’ head-to-head clinical trial data. Despite this perceptual competitive edge, Otezla has been successful at protecting its corner of the market, without losing any material share to the newcomer. In fact, US dermatologists in Spherix Global Insights’ RealTime Dynamix™: Plaque Psoriasis Q3 update estimate overall patient share for the legacy oral asset is nearly double that of Sotyktu.
Of note, Sotyktu currently has and is projected to continue to make incremental gains in market share over the next six months; however, prescriber projections reveal that Sotyktu success will more likely come at the expense of the approved injectable biologics, as opposed to Otezla. Interestingly, when dermatologists compare Sotyktu and Otezla on several attributes, including overall efficacy, clinical data, mechanism of action, overall tolerability, and dosing frequency, a greater percentage of physicians’ feel Sotyktu outperforms Otezla, apart from safety and tolerability.
Indeed, the leading IL-17 and IL-23 agents tend to rank highest in all inquired efficacy, safety, and non-clinical metrics, resulting in dermatologist reports of a very low unmet need for additional plaque psoriasis treatments. When probed specifically on what, if any, remaining needs exist, it is clear the future is oral. Specifically, prescribers desire a safe and efficacious oral option, with one respondent specifically noting, “an oral agent that is superior in efficacy to Otezla and safer than Sotyktu,” and another underscoring the need for an oral treatment with comparable efficacy to biologics, “we need an oral medicine with a clean safety profile that is as efficacious as the IL-23 injectables.”
Recognizing the future needs, the psoriasis pipeline is chock full of oral assets trying to achieve comparable biologic efficacy in a pill. In July, Janssen announced positive topline results for JNJ-2113 an oral IL-23 inhibitor licensed from Protagonist. After prompting US dermatologists with the study results, Spherix found that nearly 40% of moderate-to-severe psoriasis patients would be considered a candidate for the developmental drug, and most report a high potential of prescribing if approved. Spherix also captured where in the treatment algorithm assets such as JNJ-2113 would fit and will continue to track the evolving pipeline opportunities via it’s RealTime Dynamix™: Plaque Psoriasis service.
About RealTime Dynamix™
RealTime Dynamix™ is an independent service providing strategic guidance through quarterly or semiannual reports, which include market trending and a fresh infusion of event-driven and variable content with each wave. The reports provide an unbiased view of the competitive landscape within rapidly evolving specialty markets, fueled by robust HCP primary research and our in-house team of experts.
About Spherix Global Insights
Spherix Global Insights is a leading provider of market research, business intelligence and advisory services to the global life sciences industry. The company’s unique service offerings are powered by deep therapeutic knowledge, the Spherix Network specialty physician panel, and commercially relevant analyses to enable strategic decision-making by our valued customers.
A trusted advisor and industry thought leader, Spherix Global Insights provides specialized market expertise in six (6) focused therapeutic areas including: dermatology, gastroenterology, nephrology, neurology, rheumatology and ophthalmology.
Spherix Global Insights Contact
Gianna Melendez, Franchise Leader, Dermatology
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