AbbVie shakes up psoriasis field with blockbuster-to-be newcomer Skyrizi

Move over, Johnson & Johnson—AbbVie just joined the party with a direct competitor to Tremfya, and analysts say it might just be best-in-class.

Late Tuesday, the FDA greenlighted closely watched psoriasis prospect Skyrizi, the first IL-23 drug to hit the market after Tremfya and Sun's Ilumya. AbbVie touted its $88,500 first-year price on the new med—inclusive of two starter doses—and its $59,000 maintenance-dose price by saying it'll offer “broad and rapid access for patients.”

The annual maintenance price of Skyrizi, which is administered four times yearly, "is lower than the most widely-prescribed biologic treatments for moderate to severe plaque psoriasis,” a spokeswoman wrote by email.

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To set Skyrizi apart, AbbVie will also be pointing to a wealth of clinical data. Skyrizi “should benefit from … best-in-category efficacy,” SVB Leerink analyst Geoffrey Porges wrote in a Wednesday note to clients, calling out “stellar” phase 3 results that showed Skyrizi could clear skin lesions by 90% in up to three-quarters of patients within a week. And the AbbVie drug did that with less frequent dosing than Tremfya, which requires maintenance doses every eight weeks.

Of course, AbbVie won't just have to worry about its fellow IL-23 drugmaker. The IL-17 drug class—which now comprises Novartis’ Cosentyx, Eli Lilly’s Taltz and Valeant’s Siliq—is part of the next-gen psoriasis picture, too, as is IL-12/23 competitor Stelara from J&J and Celgene's pill Otezla.

And then there are the anti-TNF giants, led by AbbVie’s own Humira. With biosimilars on their way in that class—and Humira copies due in 2023—AbbVie is hoping Skyrizi can win patients over before the copycat meds can take hold.

And the way Porges sees it, use of anti-TNFs in psoriasis “should decrease as patients move to these new, more efficacious therapies." He figures Skyrizi will peak at $3 billion, a not-too-shabby figure, though it does fall short of AbbVie’s own $5 billion forecast for 2025.

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AbbVie isn’t expecting all of Skyrizi's sales to come from psoriasis, though. It’s anticipating $1.5 billion from inflammatory bowel disease, and to that end, Skyrizi is in phase 3 for both Crohn’s and ulcerative colitis. Data from those trials are set to roll out over the next few years.

Skyrizi also has a shot to become “an important drug in psoriatic arthritis,” Porges wrote; it's also in phase 3 for that condition.

Altogether, Skyrizi poses a threat across the psoriasis landscape, the analyst predicted. “In addition to slowing the growth of Taltz and Cosentyx and eroding the residual revenue for TNFs, longer term, we expect potent biologicals such as Tremfya and Skyrizi to threaten the robust growth trajectory of even Celgene’s Otezla,” he said.