Johnson & Johnson’s Tremfya tops Novartis blockbuster Cosentyx in head-to-head psoriasis showdown

At the 48-week mark, 84.5% of Tremfya patients in a phase 3 study achieved a score of 90 on the Psoriasis Area Severity Index. (Johnson & Johnson)

Johnson & Johnson’s Tremfya may have made its debut after key rivals, but it made waves Wednesday in the next-gen psoriasis field with Cosentyx-topping head-to-head data.

At the 48-week mark, 84.5% of Tremfya patients in a phase 3 study achieved a score of 90 on the Psoriasis Area Severity Index (PASI), a commonly used metric for measuring response to psoriasis drugs—and only 70% of patients taking the Novartis blockbuster could say the same.

The study, dubbed Eclipse, was the first to compare Tremfya, the first-in-class IL-23 inhibitor, and Cosentyx, the first-in-class IL-17 inhibitor. But as Novartis was quick to point out on a call with reporters after the data were released, Tremfya didn’t make a clean sweep.

At the 12-week and 48-week marks, 84.6% of Tremfya patients hit 75 on the PASI scale, compared with Cosentyx’s 80.2%, but that difference wasn't statistically significant.  

And at week 12 only, a higher percentage of Cosentyx patients—91.6%, versus Tremfya’s 89.3%--achieved a PASI 75 response.

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“What’s happening between these two time points will be critical to know,” Sam Khalil, Ph. D., Novartis’ head of worldwide medical affairs for immunology, hepatology and dermatology, said on the call, predicting that “the Eclipse data will have limited clinical relevance.”

Johnson & Johnson, for its part, sure doesn’t think so. “To make the best recommendation for their patients from among these options, physicians need long-term comparative safety and efficacy data. We're proud to have conducted this important trial to help guide clinical practice,” Newman Yeilding, M.D., head of immunology development for J&J’s Janssen, said in a statement.

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J&J is looking to pump up Tremfya sales after hitting the scene behind a trio of IL-17 rivals. In addition to Cosentyx, Tremfya was beaten to market by Eli Lilly’s Taltz and Bausch Health’s Siliq. Meanwhile, Sun Pharma’s Ilumya joined Tremfya in the IL-23 category this year.

For the New Jersey pharma giant, Tremfya is backing Stelara, an older immunology that’s been pressured in psoriasis by all the new competition, and Remicade, a megablockbuster anti-inflammatory drug that's up against biosimilar rivals.