European approval for Skyrizi, hot on the heels of US
Welcome news, but can't replace $20bn Humira

The European Commission has approved AbbVie’s new blockbuster-in-waiting psoriasis treatment Skyrizi (risankizumab), just one week after it gained US approval.
The drug has been approved for moderate to severe plaque psoriasis in adult patients who are candidates for systemic therapy, and is a vitally important new approval for AbbVie, which is already seeing the rapid erosion of blockbuster Humira in Europe due to biosimilar competition.
Skyrizi, which is co-developed and co-marketed with Boehringer Ingelheim will be launched in the US in the coming weeks and will carry a list price of $59,000, though this will be heavily discounted, with European markets certain to enjoy lower prices.
AbbVie has previously forecast Skyrizi's revenues to reach $5 bn by 2023, though analysts at Clarivate predict a much more modest $1.73bn by this date.
Much of its commercial success will depend on how rapidly it can additional indications to its roster, and how it fares in the market place and in head-to-head trials against a number of key competitors.
Skyrizi is entering a crowded field, and AbbVie has armed it with some strong head-to-head studies with existing treatments. Two studies compared risankizumab to J&J’s $4bn-a-year IL-12/IL-23 inhibitor Stelara (ustekinumab) and one against its own TNF inhibitor Humira (adalimumab), currently the biggest-selling drug in the world with revenues of nearly $20bn in 2018.
The analysis showed that 56% of patients on risankizumab were symptom-free after a year’s treatment, compared to 30% of the Stelara group.
The drug is already in trials for psoriatic arthritis, Crohn's disease and ulcerative colitis.
Skyrizi (150 mg) is approved for administration via two subcutaneous injections every 12 weeks following two initiation doses.
"This approval is an important step forward in providing people living with moderate to severe psoriasis with a new treatment option," said Michael Severino, M.D., vice chairman and president, AbbVie.
"The results seen in our clinical studies, including high levels of complete skin clearance with 12-week dosing and a favourable safety profile, suggest Skyrizi has the potential to provide long-term relief from the signs and symptoms of psoriasis. We are proud to expand our portfolio of treatment options for people living with this condition in Europe."
The drug received EC approval based on four pivotal phase 3 studies, ultIMMa-1, ultIMMa-2, IMMvent and IMMhance evaluating more than 2,000 patients with moderate to severe plaque psoriasis.1-4 Across all four studies, the co-primary endpoints were at least a 90% improvement in the Psoriasis Area and Severity Index (PASI 90) and a static Physician Global Assessment (sPGA) score of clear or almost clear (sPGA 0/1) at week 16.1-4
AbbVie is also hoping for approval of another tipped immunology blockbuster upadacitinib, which was accepted by the FDA two months ago under its priority review scheme.
The EU approval for the drug, just one week after the FDA’s green light is unusual, with Europe frequently having to wait six months or more to follow the US.
欧盟委员会已经批准了 AbbVie 的新重磅炸弹级等待中的银屑病治疗药物 Skyrizi (risankizumab),仅在获得美国批准一周后。该药已被批准用于全身治疗的候选成人患者的中度至重度斑块状银屑病,是艾伯维 (AbbVie) 一项至关重要的新批准,艾伯维已经看到重磅炸弹 Humira 在欧洲因生物仿制药竞争而迅速受到侵蚀。Skyrizi 与勃林格殷格翰合作开发并共同上市,将于未来几周在美国上市,其定价为 59000 美元,不过这将是严重打折的,欧洲市场肯定会享受更低的价格。艾伯维此前曾预测,到 2023 年,Skyrizi 的收入将达到 50 亿美元,但 Clarivate 的分析师预计,到 2023 年,Skyrizi 的收入将减少 17.3 亿美元。它在商业上的成功在很大程度上取决于它能以多快的速度在其花名册上增加更多的适应症,以及它在市场上和在与许多主要竞争对手的头对头试验中的表现如何。Skyrizi 正在进入一个拥挤的领域,艾伯维 (AbbVie) 为其武装了一些强大的头对头研究与现有的治疗方法。两项研究将 risankizumab 与强生每年 40 亿美元的 IL-12/IL-23 抑制剂 Stelara (ustekinumab) 进行了比较,一项研究与自身的 TNF 抑制剂 Humira (adalimumab) 进行了比较,后者目前是全球销量最大的药物,2018 年收入近 200 亿美元。分析显示,接受 risankizumab 治疗一年后 56% 的患者无症状,而 Stelara 组为 30%。该药物已经在试验用于银屑病关节炎、克罗恩病和溃疡性结肠炎。批准 Skyrizi (150 mg) 在两次起始给药后每 12 周通过两次皮下注射给药。AbbVie 副主席兼总裁 Michael Severino 医学博士说,此次批准是向为中重度银屑病患者提供一种新的治疗选择迈出的重要一步。在我们的临床研究中看到的结果,包括 12 周给药的高水平的完全皮肤清除和良好的安全性,表明 Skyrizi 有可能提供长期缓解银屑病的体征和症状。我们很自豪地扩大我们的产品组合的治疗方案,为人民生活在这种条件下在欧洲。' 该药获得 EC 批准是基于 4 项关键性 3 期研究,ultIMMa-1、ultIMMa-2、IMMvent 和 IMMhance 评估 2000 多名中度至重度斑块状银屑病患者。1-4 在所有 4 项研究中,共同主要终点是银屑病面积和严重程度指数 (PASI 90) 至少改善 90%,并且在第 16.1-4 周,静态医生整体评估 (sPGA) 评分为明确或基本明确 (sPGA 0/1),AbbVie 还希望获得另一个头端免疫学重磅炸弹 upadacitinib 的批准,该药物在两个月前根据其优先审评计划被 FDA 接受。欧盟对该药物的批准,仅仅一周后 FDA 的绿灯就不同寻常,欧洲经常不得不等待 6 个月或更长时间才能跟进美国
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