AAD: AbbVie's Skyrizi clears psoriasis symptoms where Novartis' Cosentyx, Lilly's Taltz couldn't

AbbVie’s Skyrizi has already made a name alongside the likes of Novartis’ Cosentyx and Eli Lilly’s Taltz as a powerful biologic for psoriasis. Now, the AbbVie therapy showed it could help patients when those two rival drugs failed to deliver.

After a year of treatment, Skyrizi completely cleared skin or left only minimal disease in 63% of patients with moderate to severe plaque psoriasis who had a suboptimal response to either Cosentyx or Taltz. The result, from a single-arm phase 3b trial, was presented at the 2023 American Academy of Dermatology annual meeting.

The data contributed to “the whole of evidence supporting [Skyrizi] use in moderate to severe plaque psoriasis,” Richard Warren from the University of Manchester and Norten Care, who presented the data at AAD, said in a statement.

Before the latest trial win, Skyrizi had previously beaten Cosentyx in a head-to-head phase 3b trial in psoriasis. The current trial looked at patients who had a suboptimal response to Cosentyx or Taltz. These patients scored 2 or 3 on a static Physician’s Global Assessment (sPGA) of psoriasis severity before entering the trial and had on average been on either of those two meds for over two years.

Skyrizi’s benefit was already apparent at week 16, helping 56.3% of patients achieve clear or almost clear skin defined by sPGA score of 0 or 1, respectively. At that time, 19.8% of patients achieved complete clearance.

By week 52, the percentage of patients who had clear skin reached 26.2%, and the combined sPGA 0/1 rate hit 63%.

On a patient-reported endpoint as measured by the Dermatology Life Quality Index (DLQI), 46.5% of patients reported no impact from the skin disease on their quality of life at week 52, as reflected in a DLQI score of 0 or 1.

The new data package “underscores the important role of Skyrizi in helping patients in a difficult-to-treat population achieve skin clearance and a resolution of their burdensome psoriasis symptoms,” AbbVie’s VP of global medical affairs, Nicole Selenko-Gebauer, M.D., said in a statement.

While Skyrizi showed it could help many patients who had unresolved psoriasis following Cosentyx or Taltz, the results didn’t necessarily prove that the AbbVie drug is better than the other two drugs. Skyrizi targets the inflammatory cytokine IL-23, while Cosentyx and Taltz are IL-17A antibodies. Patients sometimes cycle through different therapies.

Doctors clearly like Skyrizi. Sales of the AbbVie drug jumped 76% year over year to $5.2 billion in 2022, surpassing Cosentyx, which brought in $4.8 billion and had 1% growth. The sales figure even exceeded AbbVie’s original expectations by more than $750 million, AbbVie’s Chief Commercial Officer Jeff Stewart said on the company’s fourth-quarter earnings call.

Skyrizi was first approved in 2019 in plaque psoriasis, and it added psoriatic arthritis and Crohn’s disease last year. Cosentyx has been on the U.S. market since early 2015. But by the end of 2022, Skyrizi had snagged 28% of U.S. psoriatic disease market share among biologics, and has been getting nearly half of all new and switching patients, Stewart said.

Taltz is the smallest asset among the three, with 2022 sales of $2.5 billion after 12% year-over-year growth.

AbbVie isn’t done with building Skyrizi’s data package. Also in psoriasis, the Illinois pharma is pitting Skyrizi against Amgen’s oral drug Otezla in psoriasis, and it expects to readout phase 3 data for Skyrizi in ulcerative colitis by June.