Docs adopt Takeda’s Eohilia, challenging Sanofi and Regeneron's Dupixent

Takeda's revival of the previously rejected drug Eohilia appears to be a success, as evidenced by a recent survey of physicians. The survey indicates that the launch of Eohilia is on par with the rollout of Dupixent, another treatment for eosinophilic esophagitis, and is even causing delays in the use of Regeneron and Sanofi's blockbuster drug.

Initially, the FDA rejected Eohilia, known as TAK-721 during its development, for treating eosinophilic esophagitis in 2021. Following the rejection, Takeda seemed to abandon the drug, citing the inability to justify the additional studies required for approval. However, the company found a way to revive the drug in 2023 and successfully secured FDA approval in February.

Three months after the launch, Spherix Global Insights conducted a survey involving 75 U.S. physicians who treat eosinophilic esophagitis. The findings revealed that the trial rates of Eohilia were similar to those of Dupixent at a comparable stage in its launch. More than half of the surveyed physicians had prescribed Eohilia, and the "breadth of patient initiations" for the drug surpassed that of Dupixent.

Projections for six months post-launch suggest that Eohilia's user base could rival that of Dupixent. Spherix anticipates that Takeda’s market share will increase fourfold. These forecasts underscore Eohilia's potential to fill a significant gap in eosinophilic esophagitis treatment options.

One physician highlighted the improvement Eohilia offers over previous treatments, stating, "I have been treating this disease for 15 to 20 years and using topical steroids for most of that time. This is an improvement over what we had, and I am going to use more of it going forward."

Although the direct impact on Dupixent has yet to be fully realized, the survey revealed that most respondents believe Eohilia will delay their use of Regeneron and Sanofi’s drug. Two-fifths of the recent prescriptions for Eohilia would have been for Dupixent if Eohilia were not available.

Despite the positive start, physician feedback raises concerns about a significant limitation of Eohilia’s label. In a 36-week extension study, Eohilia did not perform better than a placebo, leading Takeda to base its approval application on 12-week data. This strategy secured approval but only permits 12 weeks of treatment.

One physician expressed concerns about the disease's recurrence after the 12-week treatment period. To prevent this, the physician plans to reduce the Eohilia dosage from twice to once a day and continue prescribing the medication off-label. If insurers refuse to cover off-label maintenance therapy, the physician will switch to generic budesonide.

In summary, Takeda’s Eohilia has shown promising early results, matching the launch metrics of Dupixent and impacting the use of other major drugs in the field. However, the limitation of a 12-week treatment period may pose challenges for long-term management, potentially necessitating off-label use or alternative therapies.