Sanofi’s post-Dupixent strategy came into sharper focus on Tuesday—and the picture is mixed. Lunsekimig, a bispecific Nanobody that simultaneously blocks TSLP and IL-13, met its primary endpoints in moderate-to-severe asthma and chronic rhinosinusitis with nasal polyps but missed in atopic dermatitis. That narrows the drug’s commercial scope but does not kill it. Jefferies maintained a $3 billion peak sales forecast from respiratory indications alone. The eczema miss does mean lunsekimig will not directly replace Dupixent’s largest revenue stream—the $18 billion franchise’s atopic dermatitis business—leaving Sanofi increasingly dependent on amlitelimab to carry that load. Meanwhile, AbbVie listed Humira on TrumpRx at an 86% discount, providing the clearest public example yet of how the Section 232 tariff framework is converting the threat of 100% tariffs into concrete pricing concessions. Foundayo continues its early commercial rollout as the oral GLP-1 war intensifies.
Top Story: Lunsekimig Delivers in the Lungs, Falls Short on the Skin
What Happened: Sanofi reported Phase 2 results across three studies of lunsekimig, a bispecific Nanobody composed of five linked antibody fragments designed to simultaneously block TSLP and IL-13—two of the most important inflammatory drivers of respiratory and skin disease. The results split cleanly along organ-system lines.
The Wins: Asthma and Nasal Polyps
AIRCULES (Phase 2b, moderate-to-severe asthma): Lunsekimig met its primary endpoint, demonstrating a statistically significant and clinically meaningful reduction in asthma exacerbations at 48 weeks along with improved lung function measured by pre-bronchodilator FEV1. The most important nuance in the data is that benefits were observed regardless of biomarker status—meaning lunsekimig showed activity in patients beyond the eosinophilic phenotype that current asthma biologics primarily target.
This biomarker-agnostic efficacy is the key competitive differentiator. Current biologics for severe asthma—Dupixent, AstraZeneca’s tezepelumab, GSK’s mepolizumab—work best in patients with elevated eosinophils or specific Type 2 inflammatory markers. A significant portion of the severe asthma population does not fit neatly into these biomarker-defined categories and remains underserved. If lunsekimig demonstrates consistent efficacy across biomarker subtypes in Phase 3, it could capture a patient population that existing biologics reach inconsistently.
DUET (Phase 2a, chronic rhinosinusitis with nasal polyps): Lunsekimig met its primary endpoint, reducing nasal polyp scores from baseline at Week 24 and meeting key secondary endpoints including nasal congestion/obstruction and CT-measured sinus disease burden. CRSwNP is a condition where Dupixent already has a strong market position, and lunsekimig’s success here suggests the dual TSLP/IL-13 mechanism translates effectively in upper airway inflammation.
The Miss: Atopic Dermatitis
VELVET (Phase 2b, atopic dermatitis): Lunsekimig missed its primary endpoint, failing to achieve a significant reduction in eczema severity as measured by the EASI score. Improvements were seen in secondary endpoints including skin clearance (EASI-75) and investigator global assessment, but the primary miss means the drug cannot advance into registrational development for eczema on the basis of this data package.
The miss was not entirely unexpected. Leerink Partners had previously flagged limited evidence of synergistic TSLP/IL-13 benefit in atopic dermatitis. The biology may explain why: in eczema, the inflammatory cascade involves a broader set of cytokines and immune pathways beyond TSLP and IL-13, potentially diluting the benefit of targeting just these two mediators. In the lungs—where TSLP and IL-13 play more central and concentrated roles in driving inflammation and airway remodeling—the dual-targeting approach appears to deliver additive benefit. In the skin, the same approach may not generate sufficient incremental efficacy over targeting either pathway alone.
What the Miss Means for the Dupixent Franchise
The eczema failure has direct implications for how Sanofi protects its most important commercial asset. Dupixent generated nearly $18 billion in 2025 revenue across six approved indications, with atopic dermatitis representing the largest single revenue stream. Lunsekimig was one of three pipeline candidates Sanofi has been developing to defend and extend the Dupixent franchise as competition intensifies.
With lunsekimig now positioned primarily as a respiratory asset, the atopic dermatitis succession plan falls more heavily on amlitelimab, an anti-OX40L antibody currently in four Phase 3 trials for AD with a filing targeted for 2026. Earlier amlitelimab data in eczema did not fully match investor expectations relative to Dupixent’s established efficacy benchmark, which has created skepticism about whether it can truly serve as a franchise successor.
Sanofi’s third pipeline candidate, itepekimab (anti-IL-33, partnered with Regeneron), is in Phase 3 for COPD and CRSwNP and Phase 2 for bronchiectasis. Itepekimab targets a different inflammatory pathway entirely and does not compete directly with Dupixent’s mechanism.
The strategic reality is that no single pipeline candidate individually replaces Dupixent’s commercial breadth across six indications. Sanofi’s bet is that the combined coverage of all three programs—lunsekimig in respiratory, amlitelimab in dermatology, itepekimab in upper airway and pulmonary disease—protects more of the inflammatory disease landscape than any single successor could. Whether the market rewards a multi-candidate franchise defense or penalizes the fragmentation remains to be seen.
The Respiratory Commercial Path
Despite the eczema miss, lunsekimig’s respiratory path is intact and substantial. Sanofi already has the drug in two Phase 3 COPD studies (PERSEPHONE and THESEUS) and a Phase 2 study in high-risk asthma (AIRLYMPUS). Sanofi’s R&D chief Houman Ashrafian called the respiratory data “promising” and said it supports “the dual-targeting mechanism of lunsekimig.”
Jefferies analyst Michael Leuchten maintained a $3 billion peak sales forecast from respiratory indications alone. That is a significant commercial opportunity independent of eczema. The severe asthma biologic market exceeds $10 billion annually, and COPD represents an even larger patient population where biologic therapy penetration remains low. If lunsekimig can establish itself as the biomarker-agnostic option in severe asthma and demonstrate COPD efficacy in Phase 3, the respiratory franchise alone justifies continued investment.
Our Pro brief includes a full analysis of Sanofi’s three-candidate franchise defense strategy, how lunsekimig positions against tezepelumab and Dupixent in the respiratory biologic landscape, and the increased pressure on amlitelimab to deliver in atopic dermatitis. [Details below.]
What to Watch
Detailed lunsekimig results from AIRCULES and DUET will be presented at upcoming medical congresses. The magnitude of exacerbation reduction in asthma and the lung function improvements relative to existing biologics will determine competitive positioning. The Phase 3 COPD readouts (PERSEPHONE and THESEUS) become the definitive registrational catalysts for the respiratory franchise. And the amlitelimab filing timeline in 2026 takes on significantly greater urgency now that lunsekimig is out of the eczema picture.
AbbVie Lists Humira on TrumpRx at 86% Discount
What Happened: AbbVie has listed Humira on TrumpRx, the administration’s direct-to-consumer drug pricing platform, at an 86% discount, according to media reports cited by BioSpace. The move is part of AbbVie’s agreement with the White House to secure tariff exemptions under the Section 232 pharmaceutical tariff framework.
Why 86% Off on Humira Is a Low-Cost Concession
The discount looks dramatic on paper, but the economics tell a different story. Humira has already lost more than half its U.S. revenue to biosimilar competition since Amjevita launched in January 2023. The remaining branded Humira revenue is concentrated in patients who have not switched to biosimilars and may never switch—a declining base that AbbVie is managing for cash flow rather than growth.
Offering an 86% discount on a product in structural decline costs AbbVie relatively little compared to the alternative: facing 100% tariffs on its entire patented portfolio, which includes the high-growth franchises Skyrizi and Rinvoq that represent AbbVie’s future. The tariff framework creates a simple calculation—make the pricing concession cheaper than the tariff—and Humira is the ideal product to use for that concession because the revenue impact is concentrated on a franchise that is already shrinking.
The Template for What Comes Next
AbbVie’s move establishes the template every major pharma company will follow. The products that appear on TrumpRx will disproportionately be older brands facing generic or biosimilar competition, not the high-growth launches where pricing power matters most. The administration gets headlines about lower drug prices. Pharma protects its growth drivers. Both sides can declare victory.
Expect more companies to list products at steep discounts as the July 31 tariff effective date approaches for the 17 large companies in Annex III. The tariff framework is functioning exactly as designed: converting the threat of punitive tariffs into voluntary pricing concessions on products where the commercial cost to the manufacturer is manageable.
Our Pro brief analyzes why AbbVie’s 86% discount is the template for every MFN deal to follow, which products other companies are likely to list, and how the tariff-driven pricing cascade affects the broader drug pricing policy trajectory. [Details below.]
Industry Data
Medtech Financing Holds Strong in Q1 2026
BioWorld reported that medtech financing in Q1 2026 reached $8.54 billion, a modest decline from $9.33 billion in Q1 2025 but well above the $6.45 billion recorded in Q1 2024 and $4.69 billion in Q1 2023.
Why This Matters: The data signals continued recovery from the post-2021 medtech funding downturn, with financing levels stabilizing at healthy levels above pre-pandemic norms. The modest year-over-year dip may reflect capital rotating toward biopharma M&A targets, where elevated deal premiums (38% to 140% in Q1) are attracting investment capital that might otherwise flow to medtech startups. The medical device sector also faces the overhang of an active Section 232 investigation, with the Commerce Department report expected by late May—a regulatory uncertainty that could be suppressing some early-stage financing activity.
Foundayo Commercial Update
Lilly’s Foundayo (orforglipron) continues its early commercial rollout following last week’s FDA approval. LillyDirect shipping is underway, and retail pharmacy and telehealth provider availability is expanding. The $149 per month self-pay pricing at the lowest dose positions Foundayo alongside Novo’s Wegovy pill at the same entry price point.
The first full week of commercial availability will begin generating initial prescription volume data over the next two to four weeks. This data will provide the first competitive signal in the oral GLP-1 head-to-head battle. The key metrics to watch: total new prescriptions, the split between LillyDirect and retail pharmacy channels, and early signals on dose escalation patterns from the $149 starting dose to the higher-dose tiers at up to $399 per month.
Strategic Themes
1. Dual-Targeting Does Not Automatically Mean Dual-Indication
Lunsekimig’s split results are a reminder that bispecific mechanisms do not guarantee efficacy across every disease where the targets are relevant. TSLP and IL-13 both contribute to inflammation in the lungs and the skin, but the biological context differs enough that simultaneously blocking both mediators produces meaningful clinical benefit in one organ system and not the other. Drug developers pursuing multi-target bispecifics should expect indication-specific outcomes rather than assuming that target relevance automatically translates to clinical efficacy across disease areas.
2. The Dupixent Succession Plan Just Got More Complicated
Lunsekimig’s exit from the eczema pipeline increases the pressure on amlitelimab to deliver a Dupixent-competitive efficacy profile in atopic dermatitis. Sanofi’s three-candidate strategy was designed to provide redundancy—if one candidate missed in a particular indication, the others could fill the gap. With lunsekimig now limited to respiratory, the franchise defense becomes more dependent on amlitelimab’s Phase 3 outcomes and filing timeline in 2026. Any disappointment in the amlitelimab data would leave Sanofi without a clear atopic dermatitis successor for its largest revenue franchise.
3. The Section 232 Tariff Framework Is Converting Threats into Concessions at Scale
AbbVie’s 86% Humira discount on TrumpRx is the most visible example of a pattern that will repeat across the industry. The tariff structure creates a simple economic calculus: make pricing concessions on products where the commercial cost is manageable in exchange for 0% tariffs on the entire patented portfolio. The result is predictable—companies will sacrifice margin on declining or competitive products to protect pricing power on their growth drivers. Whether this constitutes genuine drug pricing reform or strategic compliance depends on your perspective, but the mechanism is functioning as the administration intended.
4. Sanofi’s Respiratory Opportunity Is Large Even Without Eczema
A $3 billion peak sales forecast for lunsekimig from respiratory indications alone is a substantial commercial opportunity. The severe asthma biologic market exceeds $10 billion annually, and COPD biologic penetration remains early-stage. If lunsekimig’s biomarker-agnostic efficacy profile holds in Phase 3—particularly in the COPD studies—Sanofi would have a differentiated respiratory franchise that does not depend on replacing Dupixent but rather expands the total addressable market for biologic therapy in lung disease.
Frequently Asked Questions
What is lunsekimig, and what did the Phase 2 results show?
Lunsekimig is a bispecific Nanobody that simultaneously blocks TSLP and IL-13, two key inflammatory mediators. Phase 2 results showed the drug met primary endpoints in moderate-to-severe asthma (AIRCULES) and chronic rhinosinusitis with nasal polyps (DUET) but missed its primary endpoint in atopic dermatitis (VELVET). The drug is now positioned primarily as a respiratory candidate with Jefferies projecting $3 billion in peak sales from respiratory indications alone.
Why did lunsekimig work in asthma but not in eczema?
The biology likely explains the split. In the lungs, TSLP and IL-13 play central, concentrated roles in driving inflammation and airway remodeling, making simultaneous blockade highly effective. In the skin, the inflammatory cascade involves a broader set of cytokines and immune pathways, potentially diluting the benefit of targeting just these two mediators. Leerink Partners had previously flagged limited evidence of synergistic TSLP/IL-13 benefit in atopic dermatitis.
What does the eczema miss mean for Dupixent’s future?
Lunsekimig will not directly replace Dupixent in atopic dermatitis, shifting that responsibility to amlitelimab, an anti-OX40L antibody in Phase 3 with a filing targeted for 2026. Dupixent generated nearly $18 billion in 2025 revenue, with atopic dermatitis as the largest revenue stream. The pressure on amlitelimab to deliver Dupixent-competitive efficacy has increased significantly.
What other pipeline candidates does Sanofi have for its immunology franchise?
Three candidates: lunsekimig (TSLP/IL-13 bispecific, now respiratory-focused), amlitelimab (anti-OX40L, Phase 3 in AD with 2026 filing target), and itepekimab (anti-IL-33, partnered with Regeneron, Phase 3 in COPD and CRSwNP). Together they are designed to cover more of the inflammatory disease landscape than any single Dupixent successor could, but no individual candidate replaces Dupixent’s commercial breadth across six indications.
Why did AbbVie list Humira on TrumpRx at 86% off?
Humira has already lost substantial revenue to biosimilar competition. Offering a steep discount on a declining product is a low-cost way to secure tariff exemptions under the Section 232 framework, which offers 0% tariffs for companies with MFN pricing agreements. The alternative—100% tariffs on AbbVie’s entire patented portfolio including high-growth assets Skyrizi and Rinvoq—would be far more costly than the Humira pricing concession.
How is the Foundayo launch progressing?
LillyDirect shipping started April 6. Retail pharmacy and telehealth availability is expanding. Self-pay pricing starts at $149 per month at the lowest dose. Initial prescription volume data is expected over the next two to four weeks and will provide the first competitive signal against Novo’s oral Wegovy, which launched in January at the same $149 entry price point.
What does the medtech financing data show?
Medtech financing reached $8.54 billion in Q1 2026, down modestly from $9.33 billion in Q1 2025 but well above Q1 2024 ($6.45 billion) and Q1 2023 ($4.69 billion). The sector continues to recover from the post-2021 funding downturn, though the year-over-year dip may reflect capital rotating toward elevated biopharma M&A premiums.
What is the “biomarker-agnostic” asthma signal, and why does it matter?
Current asthma biologics work best in patients with elevated eosinophils or specific Type 2 inflammatory markers, leaving a significant portion of the severe asthma population underserved. Lunsekimig showed benefits regardless of biomarker status, meaning it could potentially treat patients beyond the eosinophilic phenotype. If confirmed in Phase 3, this biomarker-agnostic profile would differentiate lunsekimig from Dupixent, tezepelumab, and other biologics that depend on patient selection based on inflammatory markers.
BioMed Nexus Pro — What Institutional Subscribers Are Reading Today
Sanofi’s Post-Dupixent Playbook: Three Candidates, One Franchise at Stake. We map the three-candidate defense strategy—lunsekimig in respiratory, amlitelimab in dermatology, itepekimab in upper airway—and assess whether the combined coverage protects an $18B franchise or fragments the succession plan into commercially subscale pieces.
Tariff Pricing Cascade: AbbVie’s 86% Template. We analyze why listing declining products on TrumpRx at steep discounts is the optimal strategy for every major pharma company, identify which products other manufacturers are likely to offer next, and assess how the tariff-driven pricing cascade affects the broader drug pricing policy trajectory.
Respiratory Biologic Landscape: Where Lunsekimig Fits. We compare lunsekimig’s biomarker-agnostic profile against tezepelumab, Dupixent, mepolizumab, and emerging competitors across the severe asthma and COPD biologic markets, with commercial modeling for the respiratory-only franchise.
Plus: Foundayo first-week monitoring, amlitelimab filing timeline pressure, medtech financing trends, and the updated catalyst calendar through H2 2026.
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