Latest Biologic Launch in Psoriasis, UCB's Cimzia, Having a Tough Time Getting Traction, But Developing a Presence in Dermatology May Lay Foundation for Bimekizumab in the Future

Janssen's Tremfya continues to post gains, but may soon face competition as Sun Dermatology readies for the launch of Ilumya (tildrakizumab), the second IL-23 inhibitor to be introduced in the U.S. market, according to a new report from Spherix Global Insights

In the latest quarterly survey of 102 U.S. dermatologists conducted in August 2018, the launch of Cimzia (certolizumab pegol) is benchmarked against other recent launches in psoriasis including Eli Lilly’s Taltz (ixekizumab), Ortho Dermatologics’ Siliq (brodalumab) and Tremfya (guselkumab). Early assessment of Cimzia three months post-launch suggests the brand has some serious hurdles to overcome.

As the fourth TNF inhibitor in a TNF-shrinking market, one should not be surprised by the lackluster reaction to Cimzia. Fewer than 10 percent of survey respondents have prescribed the drug since launch, and the level of promotion seriously lags that of competitors, with only 23 percent receiving a call from a UCB sales representative in the past month, compared to 67 percent for Novartis’ Cosentyx (secukinumab). As one dermatologist stated, “I have never heard of it, didn’t know it was available, haven’t met with a rep.” UCB’s saving grace may be its positioning of Cimzia for women of childbearing age and women who are pregnant or likely to become pregnant. A growing percentage of respondents are aware of UCB’s CRIB and CRADLE studies and indicate they are more likely to prescribe Cimzia as a result of the study findings. While Cimzia may not be resonating with dermatologists, UCB’s pipeline asset, bimekizumab, a humanized IgG1 monoclonal antibody which uniquely neutralizes both IL-17A and IL-17F, may find a more receptive audience. Among several late-stage products in development, more than one-third would most like to see bimekizumab approved.

I have never heard of it, didn't know it was available, haven't met with a rep.

Dermatologist on Cimzia (UCB)

The psoriasis market also continues its shift toward increased use of alternative mechanism biologics, with Tremfya enjoying the most favorable momentum. A growing percentage of dermatologists indicate that Tremfya is their top choice among alternate mechanism of action (AMOA) biologics, for the first time surpassing combined preference for the IL-17s, Cosentyx and Taltz. Since the beginning of the year, there has been a sharp uptick in the use Tremfya as a first-line biologic, largely fueled by a generous patient assistance program. According to RealWorld Dynamix: Biologic and Small Molecule New Starts in Psoriasis, a retrospective patient chart audit, patients treated with Tremfya were significantly more likely to partake in free drug programs than those on any other agent. However, one-third of respondents believe that once Tremfya’s free drug program is over, payers will not cover patients, which could dent the share gains the brand has recently captured.

Brands now need to battle beyond skin clearance, since dermatologists largely perceive Tremfya, Cosentyx and Taltz to perform similarly. In an effort to do just that, Eli Lilly conducted a trial of Taltz in patients with genital psoriasis1.  While the results were favorable for Taltz, more than one-third believe this is an IL-17 class effect and not brand specific. Similarly, while Novartis has been emphasizing five-year efficacy and safety data with Cosentyx, roughly half of the respondents consider the IL-17s to be equivalent on “sustained response” and the rest are equally divided as to whether Cosentyx or Taltz is better. Seeking out unique patient characteristics to study and align one’s brand seems to be the next evolution of marketing in this crowded space.

The psoriasis market is about to get even more crowded. Sun Dermatology expects to launch its IL-23 inhibitor, Ilumya (tildrakizumab), in the coming quarter. The majority of dermatologists are not aware of IIumya’s FDA approval and expect Ilumya to experience a slow uptake once it launches. Ilumya’s label, calling for administration by a health care professional, may be a double-edged sword as less than 20 percent of dermatologists believe the 12-week dosing schedule to be an advantage over Tremfya’s eight-week dosing schedule, and many express reluctance to administer a subcutaneous agent in their office. They will likely have a short window as another IL-23 inhibitor, in the form of AbbVie’s risankizumab, is not far behind in the pipeline.

The RealTime Dynamix™: Psoriasis US report series provides a quarterly detailed and timely look at current and future trends in the psoriasis market and the effects of the future shifting landscape. The series tracks the evolution of the market, provides a deep dive on launch effectiveness and highlights opportunities for pipeline agents.

RealWorld Dynamix: Biologic and Small Molecule New Starts in Psoriasis integrates physician survey responses with in-depth audits of over 1,000 patients with psoriasis who were recently initiated on their first-line biologic or Otezla. A similar publication, RealWorld Dynamix™: Biologic and Small Molecule Switching in Psoriasis, is a robust patient chart analysis of +/- 1,000 psoriasis patients who were switched from one biologic or Otezla to a different brand in the past three months. The second annual wave of this report will publish in October 2018.

About Spherix Global Insights
Spherix Global Insights is an independent business intelligence and market research company, specializing in renal, autoimmune, neurologic and rare disease markets. Our aim is to apply our commercial experience and unique relationships within core specialty markets to translate data into insight, enabling our clients to make smarter business decisions.

All company, brand or product names in this document are trademarks of their respective holders.

For more information contact:
Lynn Price, Immunology Franchise Head

1 Source: Eli Lilly, May 22, 2018,

Source: Spherix Global Insights


Categories: Pharmaceuticals and Biotech

Tags: cimzia, cosentyx, dermatology, ilumya, pso, psoriasis, taltz, trefmya