Some Crohn's drugs already start with injections or a pill, but most IL-23 drugs still begin with clinic or hospital infusions. AbbVie wants to change that for Skyrizi, after its AFFIRM trial showed that starting with injections works.
Humira, Cimzia and Rinvoq already start at home, but most IL-23 drugs, among the higher-efficacy Crohn's options, still begin with infusions. Tremfya already offers injections from the first dose; AbbVie has filed the same for Skyrizi after its Phase 3 AFFIRM trial met both week-12 goals (clinical remission 55% vs 29.6%; endoscopic response 44% vs 14.3%); Omvoh still needs an infusion. A table of how every advanced Crohn's drug starts, what AFFIRM showed, and why no trial yet shows whether injections work as well as the infusion.
Pfizer, Amgen, Lilly, Merck, and Astellas all failed at IGF-1R in cancer. Then a shelved Roche antibody became the only effective treatment for thyroid eye disease. Same receptor, completely different biology.
Five major pharmas spent two decades chasing IGF-1R as a cancer target. Every Phase 3 trial failed. The only IGF-1R drug ever approved is for thyroid eye disease — Tepezza, which generated $1.9 billion in 2024 and 8x exceeded its acquirer's peak forecast. Eleven more IGF-1R-for-TED programs are now in clinical trials, including the literal cancer-graveyard compound being resurrected by Sling Therapeutics. Targets don't travel. Disease context decides.
Two drugs finally broke through. They work only before most patients are ever diagnosed.
Alzheimer's drug development has a 99.6% failure rate - the highest of any disease. Between 2003 and 2021, zero new treatments were approved while $42.5 billion was spent on clinical trials. Then lecanemab and donanemab broke through. But 27% slowing of cognitive decline, brain swelling in up to 1 in 4 patients, and $26,000/year raises the question: is this enough?
