Targeted Therapies In Asthma: KOL Insight

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Publication Date:
January 2016
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Competition heating up as developers struggle to differentiate pipeline asthma antibodies

Innovative monoclonal antibodies are breathing new life into the treatment of severe asthma. But with many of them targeting similar populations and providing similar benefits, finding a competitive edge won’t be easy.

Learn how key opinion leaders (KOLs) expect developers to differentiate their pipeline asthma antibodies in KOL Insight: Targeted Therapies in Asthma.

You’ll hear how 12 US and European KOLs think the competitive landscape will evolve as pipeline drugs challenge mainstay treatment, Xolair, and GlaxoSmithKline’s Nucala—the first new antibody to market.

View: North American KOLs, EU KOLs, marketed antibodies, pipeline antibodies

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Answering Key Questions

Get answers to key questions about marketed and pipeline monoclonal antibodies for severe asthma:

Marketed Drugs
Anti-IgE Antibodies:
  • Xolair (omalizumab; Novartis/Roche)
    Is Xolair’s market share at risk from new or pipeline antibody treatments?
Anti-IL-5 Antibodies:
  • Nucala (mepolizumab; GlaxoSmithKline)
    Is Nucala’s first to market advantage enough to protect it against competitors in the pipeline?
Pipeline Drugs
Anti-IgE Antibodies:
  • Ligelizumab (formerly QGE031; Novartis)
    If approved, can ligelizumab increase the eligible anti-IgE patient population? By how much?
Anti-IL-5 Antibodies:
  • Cinqair (reslizumab; Teva)
    Will Cinquair’s route of administration keep it from gaining a foothold in the market?
  • Benralizumab (formerly MEDI-563; AstraZeneca)
    Will the CALIMA and SIROCCO trials reveal which patient population is most likely to benefit from benralizumab?
Anti-IL-13 Antibodies:
  • Tralokinumab (AstraZeneca)
    Will its biweekly dosing schedule make it harder for tralokinumab to compete with Roche’s lebrikizumab?
  • Lebrikizumab (Roche)
    How do KOLs view the results of the discontinued the LUTE and VERSE trials?
Anti-IL-13/Anti-IL-4 Antibodies:
  • Dupilumab (anti-IL-4 receptor alpha antibody; Sanofi/Regeneron)
    How do KOLs think dupilumab will fit into the severe asthma treatment paradigm?
  • QBX258 (combination anti-IL-4 VAK694, and anti-IL-13 dectrekumab; Novartis)
    If approved, how will QBX258 affect market share for anti-IL-13 therapies such as tralokinumab and lebrikizumab?

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Top takeaways

  • Severe asthma market small but significant: Although a small percentage of the overall asthma market, severe asthma patients are an important population for drug makers. Find out why.
  • Market share for mainstay treatments: Discover whether any approved or pipeline antibodies are likely to take market share from current mainstay treatment, Xolair.
  • Potential increases in anti-IgE eligibility: Learn whether Novartis’s pipeline anti-IgE, ligelizumab can increase the overall IgE eligible population.
  • Importance of first to market advantage: Find out whether any pipeline drugs will be able to catch up to Nucala, the first new antibody to be approved.
  • Overlapping target populations: Hear how KOLs think pipeline drugs targeting similar populations, and providing similar benefits, can differentiate themselves.
  • Biomarkers as differentiators: See whether novel biomarkers can be competitive differentiators for pipeline drugs, and whether drugs that don’t require biomarkers will have an advantage.
  • Earlier-stage antibodies showing promise: Find out why some KOLs are excited about emerging IL-33, IL-23, and Anti-TSLP antibodies.

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Key issues explored

  • An underserved market: Find out how new- and pipeline therapies are broadening treatment options for severe asthma patients, reducing dependence on oral corticosteroids.
  • Patient eligibility: A relatively low percentage of patients are eligible for Anti-IgE therapy. Can more relaxed labels help newer products win market share?
  • Patient overlap: Pipeline drugs have similar targets and offer similar benefits. Can they compete on mechanism of action, delivery method, dosing schedule, secondary benefits, etc.?
  • Biomarker overlap: The biomarkers used to identify responders all target roughly the same population. Read how KOLs think that will affect treatment decisions and brands switching.
  • Antibodies as lifelong treatments: Do new antibodies have to be lifelong treatments? Find out whether KOLs think these therapies can control and modify the disease.
  • Combination therapies: Some KOLs are excited by promising dual-antibody therapies, but anticipate challenges from payers. Find out why?
  • Key clinical trials ahead: Pipeline antibodies are still undergoing clinical trials. Find out how KOLs expect trial results to affect approval and treatment decisions.

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A report based on expert knowledge

KOLs from North America
  • Gailen D Marshall. Associate professor of medicine and pathology and director of the Division of Allergy and Clinical Immunology, University of Texas-Houston Medical School, Houston, TX, USA
  • Mark FitzGerald. Director, Centre for Heart and Lung Health and Senior Scientist at the Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
  • Daniel Jackson. Assistant professor, pediatrics, section on allergy and immunology, University of Wisconsin Hospital and Clinics, Madison, WI, USA
  • Leonard Bacharier. Professor, Pediatrics and Clinical Director, Division of Allergy, Immunology and Pulmonary Medicine, Washington University School of Medicine, St. Louis, MO, USA
  • Carlos Camargo. Chair in Emergency Medicine, Massachusetts General Hospital (MGH), Boston, MA, USA
  • Juan Celedon. Pulmonologist and a genetic epidemiologist, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
KOLs from Europe
  • Anonymous. Professor of Medicine and Pneumology and Head of the Departments of Pulmonary Medicine and Intensive Care Medicine, renowned University Medical Clinic, Germany
  • Fan Chung. Professor of Respiratory Medicine and Head of Experimental Studies Medicine, National Heart & Lung Institute, Imperial College London, London, UK
  • Prof David Halpin. South West Respiratory Lead, NHS England, UK
  • Anonymous. Doctor for internal medicine and pulmonology and head of pulmonary clinic at a teaching hospital.
  • Jean Bousquet. Professor of Pulmonary Medicine, University of Montpellier, Montpellier, France.
  • Dr Arnaud Bourdin. Head of the pulmonology department, Hôpital Arnaud de Villeneuve, Montpellier, France

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