Dupixent - $6.8 billion
Stelara - $5.3 billion
Humira - $ 5.0 billion
Skyrizi - $4.7 billion
Cosentyx - $2.9 billion
Entyvio - $2.9 billion
Rinvoq - $2.5 billion
Xolair - $2.1 billion
Enbrel - $1.8 billion
Tremfya - $1.7 billion
Best-selling Immunology Drugs: A Comprehensive Overview
The field of immunology has seen significant advancements in recent years, with several drugs emerging as top-sellers due to their effectiveness in treating autoimmune and inflammatory conditions. Below, we explore some of the leading immunology drugs, detailing their FDA-approved indications, mechanisms of action, and sales figures.
1. Dupixent (Dupilumab) - $6.8 billion
Indications Approved by FDA:
Atopic dermatitis
Asthma
Chronic rhinosinusitis with nasal polyposis
Eosinophilic esophagitis
Prurigo nodularis
Mechanism of Action:
Dupixent is a monoclonal antibody that targets the interleukin-4 receptor alpha (IL-4Rα) subunit, which is shared by both IL-4 and IL-13 receptors. By inhibiting these cytokines, Dupixent reduces the inflammatory response that drives conditions like atopic dermatitis, asthma, and other type 2 inflammatory diseases.
2. Stelara (Ustekinumab) - $5.3 billion
Indications Approved by FDA:
Plaque psoriasis
Psoriatic arthritis
Crohn's disease
Ulcerative colitis
Mechanism of Action:
Stelara is a monoclonal antibody that targets the p40 subunit of the interleukins IL-12 and IL-23. These cytokines play a key role in the immune response and inflammation. By inhibiting IL-12 and IL-23, Stelara disrupts the inflammatory cascade that underlies conditions like psoriasis and inflammatory bowel diseases.
3. Humira (Adalimumab) - $5.0 billion
Indications Approved by FDA:
Rheumatoid arthritis
Psoriatic arthritis
Ankylosing spondylitis
Crohn's disease
Ulcerative colitis
Plaque psoriasis
Hidradenitis suppurativa
Juvenile idiopathic arthritis
Uveitis
Mechanism of Action:
Humira is a TNF (tumor necrosis factor) inhibitor. TNF is a cytokine involved in systemic inflammation and is a key driver in autoimmune diseases. By binding to TNF, Humira prevents it from interacting with its receptors on cell surfaces, thereby reducing inflammation and halting the progression of autoimmune diseases.
4. Skyrizi (Risankizumab) - $4.7 billion
Indications Approved by FDA:
Plaque psoriasis
Psoriatic arthritis
Crohn's disease
Mechanism of Action:
Skyrizi is a monoclonal antibody that selectively targets the p19 subunit of interleukin-23 (IL-23). IL-23 is a cytokine that plays a pivotal role in the inflammatory process associated with psoriasis and other autoimmune diseases. By inhibiting IL-23, Skyrizi reduces inflammation and the associated symptoms of these conditions.
5. Cosentyx (Secukinumab) - $2.9 billion
Indications Approved by FDA:
Plaque psoriasis
Psoriatic arthritis
Ankylosing spondylitis
Non-radiographic axial spondyloarthritis
Mechanism of Action:
Cosentyx is a monoclonal antibody that targets interleukin-17A (IL-17A), a cytokine involved in the inflammatory response. By inhibiting IL-17A, Cosentyx helps reduce the inflammation and symptoms associated with psoriasis, psoriatic arthritis, and spondyloarthritis.
6. Entyvio (Vedolizumab) - $2.9 billion
Indications Approved by FDA:
Crohn's disease
Ulcerative colitis
Mechanism of Action:
Entyvio is a monoclonal antibody that targets the integrin α4β7, which is involved in the migration of T cells into the gut tissue. By inhibiting this integrin, Entyvio reduces the influx of inflammatory T cells into the gut, thereby decreasing the inflammation and symptoms of Crohn's disease and ulcerative colitis.
7. Rinvoq (Upadacitinib) - $2.5 billion
Indications Approved by FDA:
Rheumatoid arthritis
Psoriatic arthritis
Ankylosing spondylitis
Atopic dermatitis
Ulcerative colitis
Crohn's disease
Mechanism of Action:
Rinvoq is a Janus kinase (JAK) inhibitor that targets the JAK1 enzyme. By inhibiting JAK1, Rinvoq interferes with the JAK-STAT signaling pathway, which is involved in the inflammatory response. This inhibition reduces the production of pro-inflammatory cytokines, alleviating symptoms in a variety of autoimmune and inflammatory conditions.
8. Xolair (Omalizumab) - $2.1 billion
Indications Approved by FDA:
Moderate to severe persistent asthma
Chronic idiopathic urticaria
Nasal polyps
Mechanism of Action:
Xolair is a monoclonal antibody that targets immunoglobulin E (IgE). By binding to IgE, Xolair prevents it from interacting with its receptor on mast cells and basophils, reducing the release of histamine and other mediators of allergic inflammation. This mechanism is particularly effective in treating asthma, chronic urticaria, and nasal polyps.
9. Enbrel (Etanercept) - $1.8 billion
Indications Approved by FDA:
Rheumatoid arthritis
Psoriatic arthritis
Ankylosing spondylitis
Plaque psoriasis
Polyarticular juvenile idiopathic arthritis
Mechanism of Action:
Enbrel is a TNF inhibitor, similar to Humira. It is a fusion protein that combines the TNF receptor with the Fc portion of IgG1, effectively acting as a decoy receptor for TNF. By binding to TNF, Enbrel reduces inflammation and controls the symptoms of autoimmune diseases.
10. Tremfya (Guselkumab) - $1.7 billion
Indications Approved by FDA:
Plaque psoriasis
Psoriatic arthritis
Mechanism of Action:
Tremfya is a monoclonal antibody that targets the p19 subunit of IL-23, similar to Skyrizi. By inhibiting IL-23, Tremfya disrupts the inflammatory process associated with psoriasis and psoriatic arthritis, leading to a reduction in symptoms and disease activity.
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