Highlights

I think individualized medicine, and by that I mean matching a medicine to a person’s DNA profile, because we now have half a dozen medications we can choose from, and we don’t have a good sense for what the right medicine for a given individual is. But there are some suggestions that we may be headed that way, and I say that because with Skyrizi, it seems that it is more appropriate or more effective in patients that also have psoriatic arthritis. So, there is something about those patients that makes them respond better to the anti-IL23 in Skyrizi.

This is truly intuitive, but I would tend to think that Skyrizi is safer because it targets fewer interleukins, and right now there is just a lot that we don’t know. So, I tend to think the more focused the target, the safer the drug.

I personally have just not had great experience with it, that is of the patients that have failed it, or the drugs that I’ve used, I would say I’ve had the most failures with Entyvio. So, I reserve it for folks that I’m very concerned about infection or malignancy, and who have milder disease.

So, it’s the ideal molecule for women that want to get pregnant, and I think it’s a good product, it’s just a little bit of an undermarketed product. If you look at the history of these coming along, while Humira was out marketing itself aggressively and getting favorable insurance coverage, Cimzia was not. So, historically it was more difficult to prescribe Cimzia, so we didn’t, and my suspicion is that it’s probably about as efficacious as Humira or Remicade, but we just don’t use it as much because we never did, and I’m not sure what the insurance coverage is like these days.