Trelegy swims against the respiratory current

If, having seen how sharply sales of Advair were falling, you had written off Glaxosmithkline’s efforts in respiratory medicine you would have missed the quiet rise of Trelegy Ellipta. The new drug, a triple combo licensed from Innoviva, is in rude health, and is one of the only COPD products to boast strongly growing total and new US prescriptions, according to analysts at Evercore ISI. Yesterday things got even better when Trelegy scored in the Captain study, which tested it in 2,544 asthma patients head to head against Breo Ellipta, Glaxo’s marketed asthma and COPD product. Trelegy met the primary endpoint, Glaxo said, beating Breo in terms of 24-week FEV1 for both doses tested, at p<0.001. Though the key secondary measure, annualised rate of moderate/severe exacerbations, was missed, rendering other analyses descriptive only, Glaxo said it would seek to file Trelegy in asthma on these data. EvaluatePharma sellside consensus sees Trelegy sales climbing from $208m last year to $1.4bn in 2024, but these are all derived from COPD, suggesting that use in asthma represents an added bonus. Innoviva investors seemed surprise by the Captain result, sending the company’s stock up 7% yesterday.

Selected respiratory disease combination drugs
        Sales ($m)
Drug Type Company Approved use 2018 2024e
Advair LABA + steroid Glaxosmithkline COPD/asthma 3,269 1,174
Anoro Ellitpa LABA + LAMA Glaxosmithkline/Innoviva COPD 636 1,004
Breo Ellipta LABA + steroid Glaxosmithkline/Innoviva COPD/asthma 1,454 1,544
Trelegy Ellipta LABA + LAMA + steroid Glaxosmithkline/Innoviva COPD 208 1,392
Ultibron Neohaler LABA + LAMA Novartis/Vectura COPD 454 556
Source: EvaluatePharma.

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