Competition among biologics that target inflammatory respiratory disease is heating up even further.
On Thursday, AstraZeneca said its Fasenra, used in tandem with standard steroids, significantly reduced the size of nasal polyps and the seriousness of nasal blockage among patients suffering from chronic rhinosinusitis with nasal polyps in a phase 3 trial.
While detailed data won’t be shared until a later medical meeting, the trial win once again puts Fasenra on a collision course with its in-class archrival, GlaxoSmithKline’s Nucala—which touted a similar clinical success in April—as well as Sanofi and Regeneron’s FDA-approved Dupixent.
The phase 3 Ostro trial tested Fasenra, an IL-5 inhibitor, in patients who were still suffering from nasal polyposis despite standard of care treatment, which includes corticosteroids and prior surgical removal of polyps.
Previously in the pivotal Synapse study, Nucala, when added to standard therapy, led to a median 0.71 change at week 52 from baseline on total nasal polyp score, which can range from 0 to 4 for each nostril. The GSK IL-5 biologic also saw a median 3.14 change on a nasal obstruction scale ranging from 0 to 10.
Fasenra and Nucala are already at each other’s throats in asthma. They recently introduced self-administration options on the heels of each other, and both are eyeing new indication in a rare inflammatory disease called hypereosinophilic syndrome, which is marked by an overproduction of eosinophils, a type of white blood cell.
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For now, Nucala is ahead of Fasenra by sales. In the first half of 2020, Nucala brought in £451 million ($585 million) after 28% year-over-year growth at constant currencies. Fasenra sales, meanwhile, checked in at $426 million, up 45% over the same period last year.
Rhinosinusitis with nasal polyps could be the new front for their rivalry, but if Nucala and Fasenra eventually got their FDA approvals, they will have to compete with Sanofi and Regeneron’s Dupixent, too. The IL4/IL13 inhibitor in mid-2019 became the first treatment the FDA approved for inadequately controlled rhinosinusitis with nasal polyps after showing an ability to help patients improve on polyps count and nasal congestion in two clinical trials.