Vascular endothelial growth inhibitor

And if you look at the number needed to treat, right? the number of patients who need to be exposed to amexin to get one and two remission.

If you take some of the drugs that we have in clinical trials, let's talk about just the TL1A mechanism, the tumor necrosis factor like ligand 1A.

We have a multitude of this.

There's five companies that are running that class.

Take 70% of the medications that we have on label today for UC, and then if you compare it to that class, the TL1A class, and you include the placebo rate, the clinical trials, the phase 3s, the number needed to treat utilizing that in your clinic as a first-line medication, compared to 70% of the medications we have.

The number needs to treat using that clinical trial is less than those that are on label or FDA approved, which is mind blowing to me.

I mean, I did that equation.

A Phase IIb is planned.

Now a different class, the TL1A antibodies, named for TNF-like ligand 1A.

Teva and Sanofi's Duvacatug reported 44-week maintenance data at 450 and 900 milligrams from its Phase IIb relief extension in UC and Crohn's disease.

In UC, clinical remission was 47% on the lower dose in 34 patients and 58% on the top dose in 38.

Even so, both incumbents run the same strategy, pairing their own antibody with a second mechanism to extend a franchise.

A smaller company is building the same kind of combination.

Spire Therapeutics has long-acting antibodies against alpha-4-beta-7, TL1A, and IL-23.

Each met the primary endpoint across single-arm, open-label toplines from April and September, replayed at UEG as an encore, and the combination readout comes in 2027.

It's good to see that they did find a home somewhere.

Um, Merck announced its results with, um, its investigational drug, an anti-TL1A.

That's a tumor necrosis factor-like ligand one-A.

Uh, it's an anti-inflammatory, uh, pro-inflammatory cytokine.

Theirs is called, um, Tulisco, Tulisocimab, Tulisocimab, MK-seven two four o o one two.

They had a, a positive clinical trial.

Again, all the rage with these TL, TL1A drugs that are in development.

This is the next wave, sort of the next TNF inhibitor that'll be used in IBD and derm conditions and rheuma- rheumatology and rheumatoid, except so far, mmm, you know, not more buzz than actual data.

Now Merck.

It's tulisocubart, an antibody against TL1A, was tested outside bowel disease in a phase 2b in moderate to severe hydrogenitis superativa, a painful chronic skin disease.

Merck reported top-line success in August, and this week came the numbers.

On the higher doses, 64 and 72 percent of patients at least halved their combined count of abscesses and inflammatory nodules by week 16, without more abscesses or tunnels.

Next, dermatology.

In August, Merck said tulisocubart, an antibody against TL1A, met its main goals in moderate to severe hydrodinitis superativa, a painful chronic skin disease.

Today came the numbers.

On the higher doses, 64% and 72% at least halved their combined count of abscesses and inflammatory nodules by week 16, without more abscesses or tunnels.