Lebrikizumab’s convenience edge emerges

It is a truth universally acknowledged that Lilly and Almirall’s IL-13 inhibitor lebrikizumab, if approved, will have a hard time going up against Sanofi and Regeneron’s Dupixent in atopic dermatitis. But at least the newcomers have a new weapon in their armoury: convenience. Data from the one-year maintenance periods of the pivotal Advocate-1 and 2 trials, toplined today, show lebri performing similarly when dosed every two or four weeks. Dupixent, meanwhile, is given every two weeks. The latest results build on 16-week data from the Advocate studies, which used the two-weekly dosing schedule – and showed lebri just about outdoing Dupixent. It will take a lot to get patients to switch from Dupixent, which is reflected in consensus forecasts from Evaluate Pharma: the sellside expects the Sanofi/Regeneron antibody to bring in $9.3bn in atopic dermatitis in 2028, versus lebri’s $1.5bn the same year. Still, Jefferies analysts reckon that, based on a physician survey, lebri could become the second most-prescribed biologic after Dupixent. But before the challengers can think about launch they will need to get the nod from regulators: Lilly and Almirall are planning filings in the US and Europe respectively later this year.

Cross-trial comparison of lebrikizumab & Dupixent: proportion of previous responders maintaining EASI-75 at 1 year
Lebrikizumab Q2W Q4W  
Advocate-1 79% 79%  
Advocate-2 77% 85%  
Dupixent Q1/2W Q4W Q8W
Solo-Continue 72% 58% 55%
Source: Company release & JAMA Dermatology.

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