After undershooting analyst sales forecasts in the first quarter, Eli Lilly’s psoriasis drug Taltz is on the hot seat in an immunology market packed with blockbusters. Lilly is hoping some new data on its long-term benefits can help.

After five years of treatment, Taltz significantly cleared skin in 94.3% of moderate-to-severe plaque psoriasis patients and maintained totally clear skin in 46.6% of patients, according to data presented Tuesday at the World Congress of Dermatology meeting in Milan, Italy. Lilly said the five-year data did not turn up any new side effects in the 110 patients who participated in the study.

"These results reaffirm that the high levels of skin clearance Taltz can provide early in treatment may be sustained over a long period of time," said Rhonda Pacheco, Lilly’s global brand development leader.

The positive long-term data could help Taltz make its case to physicians after the drug’s less-than-stellar performance in first-quarter sales and the recent FDA approval of AbbVie's next-gen psoriasis drug Skyrizi in April.

Taltz cleared just $252 million in global sales in the first quarter, underperforming analysts’ consensus forecast of $300 million. Credit Suisse analyst Vamil Divan said the results would "likely raise eyebrows" about Taltz’ chances as analysts keep a close eye on Lilly’s newest launches, including GLP-1 diabetes drug Trulicity.

Taltz secured 15% of the psoriasis market in the first quarter and faces major immunology challengers in AbbVie’s Humira, Novartis’ Cosentyx and Skyrizi. 

Taltz has had its share of run-ins with first-to-market Cosentyx, particularly in the hunt for FDA nods to treat ankylosing spondylitis and psoriatic arthritis (PsA). In ankylosing spondylitis, Taltz delivered significant symptom relief at the 16- and 52-week mark, according to phase 3 data released in April, in its bid to become the first IL-17A antagonist to treat the disease. However, Cosentyx is also in phase 3 trials for the same indication.

Meanwhile, Taltz has been playing catch-up with the Novartis drug in PsA. Cosentyx secured its PsA nod in January 2016—almost two years ahead of Taltz and its December 2017 approval in the indication. And two years ago, Cosentyx posted five-year skin clearance data that rival Taltz’s new numbers.

Plus, megablockbuster Humira still looms large in the market, though Lilly has been up to the challenge, at least when it comes to data.

In December 2018, Taltz bested Humira in symptom improvement at the 24-week mark for PsA patients not previously treated with a biologic. Taltz is hoping those head-to-head results will help boost its uptake in that first-line setting.

But even strong results can be middling in PsA, where Taltz is also facing Pfizer’s JAK inhibitor Xeljanz, which matched Taltz with an FDA nod for that indication in the same month, and other anti-TNF and IL-17A competitors.