Spherix Global Insights notes that differentiation among the IL-23 therapies “will be essential” as Tremfya and Omvoh look to battle class front-runner Skyrizi. (AbbVie)
The new ulcerative colitis (UC) triumvirate in Johnson & Johnson’s Tremfya, AbbVie’s Skyrizi and Eli Lilly’s Omvoh is rapidly growing into the established UC market as this IL-23 inhibitor class of drugs look to make its mark.
That’s according to a new report out by consultants at Spherix Global Insights, who found the IL-23 class “has rapidly gained significant momentum, capturing one-tenth of the advanced systemic UC market over the course of 2024.”
UC is a chronic, autoimmune bowel disease that causes ulcers and inflammation in the colon and rectum. While chronic, the disease can ebb and flow, with flare-ups often causing more severe symptoms, such as having to go to the toilet very frequently, alongside stomach and joint pain.
It is typically diagnosed in younger adults and requires lifelong treatment. Older drugs for UC have included the once megablockbuster Humira. AbbVie’s off-patent TNF blocker is, however, now being succeeded by cheaper biosimilars, namely Boehringer Ingelheim’s Cyltezo in the U.S.
More recent offerings include Bristol Myers Squibb’s Zeposia, an oral sphingosine 1-phosphate (S1P) receptor modulator approved in 2021, as well as AbbVie’s JAK inhibitor (and Skyrizi sister med) Rinvoq. Pfizer’s Zeposia rival Velsipity, also an S1P, and Takeda’s Entyvio, a TNF-alfa antagonist, are also in the space.
There are many more biologics and other older meds such as steroids and immunomodulators used for the condition.
Last year, however, a new class came into play in this already heavily catered-for market. Lilly became the first company to win FDA approval for an IL-23 inhibitor in UC in 2023, followed by AbbVie’s Skyrizi and, most recently, J&J’s Tremfya, as each drug looks to build up growing autoimmune profiles.
By talking to more than 100 doctors, Spherix found that Tremfya “has made a strong debut,” with a “large majority” of gastroenterologists aware of its September approval.
The analysts found that one-fifth of gastroenterologists have already prescribed Tremfya, “surpassing early trial rates for Lilly’s Omvoh at a similar post-launch timeframe,” though they note this falls short of what they tracked for Skyrizi.
In the coming six months, gastroenterologists told Spherix they project Tremfya’s growth to “outpace Omvoh,” positioning the J&J drug as the likely second most prescribed IL-23 therapy, behind Skyrizi, which has more understanding by doctors, having been on the market in other indications for many years.
Spherix notes that differentiation among the IL-23 therapies “will be essential” as Tremfya and Omvoh look to battle Skyrizi.
The firm points out each company is already tapping into this, with Omvoh standing out for its impact on bowel urgency, while Tremfya is noted for its dual mechanism that binds not only to IL-23 but also to CD64, a receptor on IL-23-producing cells.
Skyrizi, meanwhile, looks to distinguish itself with an on-body injector device and its earlier approval for Crohn’s disease, “which gave physicians valuable experience with the drug before its approval for UC,” Spherix notes.
