Novartis pits Cosentyx against Johnson & Johnson's Tremfya in head-to-head psoriasis study

Novartis announced Tuesday plans to start a mid-stage study comparing Cosentyx (secukinumab) to Johnson & Johnson's Tremfya (guselkumab) in patients with psoriatic plaques resistant to treatment with the latter's Stelara (ustekinumab). Results from the head-to-head ARROW trial are expected next year.

In the study, 40 patients will be randomised to receive either Cosentyx or Tremfya for 16 weeks, with the trial's primary endpoint being the percentage of patients achieving clear or almost clear status of the Stelara-resistant plaques. Novartis added that exploratory endpoints will explore the hypothesis that the direct targeting of IL-17A with Cosentyx is able to overcome IL-23 independent mechanisms of resistance.

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Cosentyx was first approved in Japan at the end of 2014 to treat both psoriasis vulgaris and psoriatic arthritis, with the IL-17A inhibitor later cleared in Europe and the US for moderate-to-severe plaque psoriasis. Novartis reported last month that sales of Cosentyx in the first quarter of 2018 climbed 41 percent year-over-year to $580 million, although the figure missed analyst estimates and was below the $615 million seen in the fourth quarter of 2017.

Analysts suggested that the lacklustre sales may be due to a more-competitive landscape in psoriasis, including from Tremfya and Eli Lilly's Taltz (ixekizumab), while CEO Vas Narasimhan conceded that price concessions had a negative effect in the quarter. For related analysis, see ViewPoints: Anxious eyes on Novartis' Cosentyx, and Physician Views Poll Results: Novartis, Johnson & Johnson continue to build case for new psoriasis therapies.

Meanwhile, MorphoSys, which licensed its HuCAL antibody library technology to Johnson & Johnson for the development of Tremfya, disclosed last year the latter's plans for a study comparing the drug to Cosentyx. The Phase III ECLIPSE trial will evaluate the efficacy of Tremfya versus Cosentyx for the treatment of moderate-to-severe plaque-type psoriasis.


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