Early Launch Metrics for Janssen's Tremfya May Lag Those of Lilly's Taltz at a Similar Post-Launch Period, but Signs Indicate the New IL-23 Inhibitor is Poised to Set a New Bar for Efficacy in Skin

EXTON, Pa., Sept. 14, 2017 /PRNewswire/ --  At just over one-month post launch, more dermatologists were aware of Taltz's approval compared to Tremfya in psoriasis (PsO).  Additionally, just under one-quarter of US dermatologists (n=98) have initiated trial with Janssen's Tremfya, a figure that wanes in comparison to the one-third of dermatologists who reportedly trialed Taltz at a similar post-launch time-frame, leading to significantly more biologic brand share than Tremfya has currently captured. 

However, despite a launch that falls short of what was witnessed for Taltz, seasonality of the launch environment and dermatologist perceptions of the growing PsO biologics market could be at play.  Indeed, Tremfya hit the market in July and over half of all surveyed dermatologists agree that they see fewer PsO patients during the summer months.  Furthermore, with the introduction of three new alternate MOAs over the past two years, in the form of Novartis' Cosentyx, Eli Lilly's Taltz, and now Janssen's Tremfya, dermatologists are struggling to find a place for these newer agents.  Over half agree that they have more biologic options than necessary for treating the disease.

In spite of a questionable unmet need for additional psoriasis treatments, the IL-17s and Tremfya are considered beneficial additions to the PsO market and the majority of dermatologists foresee alternate MOA biologics moving up to first-line therapies for some patients.  Future projections show significant brand share gains for all of the approved IL-17 agents, as well as for Tremfya, all at the expense of the established TNFs and Janssen's own Stelara.  Meanwhile, Celgene's Otezla appears to remain unscathed by the newcomers, secure for now in its position as a novel, oral small molecule option in high demand by patients.  

Dermatologists are divided about which IL-17 they prefer, as most continue to view Cosentyx and Taltz and largely interchangeable.  When specifically asked to choose one over another, 56% would choose Cosentyx, primarily related to comfort and familiarity with the first-to-market brand, while the remaining respondents chose Taltz.  Those choosing Taltz overwhelmingly attribute their selection to the brand's efficacy.

From a patient perspective, it appears as though Tremfya is poised to steal the "kings of clear skin" title from the IL-17s.  Indeed, six months ago, when asked about the preferred agent for patients seeking totally clear skin, 71% of dermatologists selected an IL-17 inhibitor, however, in the most recent survey, that figure dropped to 44%, with 28% now selecting Tremfya.  Nevertheless, when asked directly which agent Tremfya is most likely to displace, 42% indicated that Janssen's own Stelara was on the chopping block. 

RealTime Dynamix: Psoriasis is an independent report series published on a quarterly basis.  The series tracks the evolution of the PsO market, provides a deep dive on launch effectiveness, and highlights opportunities for pipeline agents.  The next wave of research will be published in December 2017.

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