- Research published Monday found GlaxoSmithKline's asthma medicine Nucala to be more effective in reducing flare-ups of the lung condition than two rival drugs, a result the British pharma was quick to highlight after failing to convince regulators to expand Nucala's label last week.
- The GSK-funded analysis, published in the Journal of Allergy and Clinical Immunology, pulled data from 11 separate trials of IL-5 targeting medicines, including Nucala, AstraZeneca's Fasenra and Teva's Cinqair. Researchers compared responses to the three drugs across groups of patients with similar blood counts of an inflammation marker called eosinophils.
- Results showed Nucala reduced clinically significant asthma exacerbations by between 34% and 54% compared with Fasenra in three subgroups, and by 45% versus Cinqair in another, GSK said. However, there were no differences between the drugs in lung function improvements or in reductions of flare-ups requiring hospitalization.
Currently, the largest franchises in asthma combine inhaled corticosteroids with bronchdilators designed to open the airways of people affected by the lung condition.
GSK, AstraZenca and Teva have bet that, for patients with severe forms of asthma marked by high counts of eosinophils, biologic medicines can play a role as well.
To date, Nucala has taken the lion's share of the IL-5 targeting market, but AstraZeneca has begun to catch up. In the week ending August 31, more than 1,600 total prescriptions for Nucala were written in the U.S., according to Iqvia data cited by Leerink. Fasenra's overall count was nearly half that, but more than twice as many new prescriptions were written for AstraZeneca's drug than were for GSK's — a trend that could eventually even the market.
"Fasenra ... has had a strong launch, and is now gaining the most new patients," wrote Cowen analyst Steve Scala in an early August note to investors. "[AstraZeneca] believes Fasenra's profile accounts for the quick uptake, with particularly positive feedback from patients regarding consistency in effect of treatment."
Scala did note, however, that Nucala looks likely to remain competitive.
Fasenra's growth will put pressure on GSK, especially as Sanofi and Regeneron's Dupixent (dupilumab), initially approved for eczema, shows potential in reducing asthma attacks in patients with high levels of eosinophils.
Keeping ahead in asthma has become more important for GSK after the Food and Drug Administration issued a complete response letter to the pharma for Nucala in chronic obstructive pulmonary disease (COPD). Though decision was expected after a negative advisory committee vote, it still closes one path to expanding Nucala's market, at least in the near term.