Aug. 1 at 8:37 PM
Here is how the IBD landscape could evolve over the next decade, assuming strong upcoming trial data for all players listed:
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$PTGX’s and
$JNJ’s Icotrokinra becoming the frontline standard of care for IBD. IL-23 pathway inhibitors already have displaced TNFi’s due to unprecedented safety and an oral IL-23 will capture a large market share from injectables as we have already seen in PsO.
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$SYRE ’s combo therapies step in for a significant percentage of monotherapy non-responders. The TL1A/IL-23 combo is in phase 2 already and Spyre also has a half-life extended alpha 4 beta 7 antibody with a 40% (!) clinical remission rate on its own that also has combo potential. All three targets have an excellent safety profile. Spyre is a prime buyout candidate, especially given strong phase 2 SKYLINE results in 2026 and 2027.
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$AGMB’s ALK5i used in fibrostenosing Crohn’s Disease, a highly unmet medical need. Patients will remain on immune pathway inhibitors like the ones above.