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Allergies are debilitating and sometimes deadly. More than a fifth of the world’s population is affected to some degree. Despite this, they are a relatively neglected area of research. That may, however, finally be changing.
Xolair, a drug originally approved in 2003 for severe asthma, recently won approval as the first FDA-approved medication to reduce allergic reactions to multiple food types. The drug, jointly marketed in the US by Novartis and Roche, allowed more than two-thirds of trialists who were allergic to peanuts to tolerate the equivalent of two and a half peanuts after about four months of treatment.
Another example of a drug that could potentially be repurposed is Dupixent, the blockbuster eczema and asthma medication owned by France’s Sanofi and the US’s Regeneron. Regeneron’s chief scientific officer George Yancopoulos has described the potential to reverse severe allergies as the drug’s “next big thing”. The research, which involves a combination of drugs, is at an early stage.
These approaches target a particular antibody that produces allergy symptoms. The traditional approach to allergy treatment — dating back as far as 1908 — is immunotherapy, a process of desensitising the patient to tiny quantities of allergens. In the US, this is normally done using a personalised cocktail of extracts, injected under the skin. However, in northern and central Europe, patients typically use standardised formulas.
The market leader in producing standardised allergens is ALK-Abelló, a 101-year-old quoted Danish company that counts the Lundbeck Foundation as its controlling shareholder. It has a 45 per cent share of the niche market that is unlikely to attract generic competition because of limited sales and manufacturing complexity. It is targeting annual sales growth of at least 10 per cent in the next five years.
ALK-Abelló is one of several companies looking at peanut allergies, the most common type of food allergy. France’s DBV Technologies is enrolling toddlers for a phase 3 trial of its novel patch technology. New York-based Intrommune Therapeutics’ desensitisation immunotherapy is delivered as toothpaste, an approach it says optimises efficacy and safety. UK-based Allergy Therapeutics, a 1999 spinout from GSK which joined the Aim market in 2004, has a novel peanut allergy vaccine in phase 1 clinical trials.
Investors’ risks are significant. Even companies where allergy trials succeed may struggle to build a market. Last September, Nestlé divested the peanut allergy business Palforzia it acquired three years earlier as part of a $2.6bn deal after disappointing take-up.
Nonetheless, allergies offer the kind of vast, hard-to-crack potential that obesity once did, an area that was long dismissed as a drug class unlikely to flourish. New research is now providing fresh insights. A big unmet need is no guarantee of a big market. But it is an important starting point.
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