Pharmaceutical Market Europe • December 2025 • 10
DARWIN'S MEDICINE
Nektar announces results from alopecia
areata study
Nektar Therapeutics has announced
top-line results from its trial of rezpegaldesleukin to treat severe-to-very-severe alopecia areata (AA).
The phase 2b REZOLVE-AA trial includes 92 patients, randomised to receive either one of two rezpegaldesleukin doses or a placebo.
In both rezpegaldesleukin dose subgroups, the majority of patients experienced hair growth at week 16 of the study or later.
The safety and tolerability profiles of rezpegaldesleukin were found to be favourable, with almost all adverse events being mild to moderate and self-resolving.
AA is an autoimmune disease where the immune system attacks the body’s hair follicles, causing hair loss. Lifetime incidence of the condition in both men and women is 2%, with nearly 6.7 million people in the US and 160 million people worldwide developing AA in their lifetime.
The US FDA granted Fast Track designation for rezpegaldesleukin twice in 2025: in July for severe AA in adults and adolescents who weigh at least 40kg and in February for inadequately controlled atopic dermatitis in adults and adolescents.
Rezpegaldesleukin is being developed as a treatment that can be self-administered as an injection for various autoimmune and inflammatory diseases.
Why do bright people make unwise decisions? I’ve researched this question, in the context of pharma and other life sciences companies, for a generation, but I’m still learning new things about it. And recently I’ve discovered a new perspective on this fascinating and important topic. Stick with me for a few minutes and I’ll share my discovery and its very practical, real-world implication for how leaders can run their meetings better.
We’ve all seen those movies where a suspect is questioned alternately by an aggressive, threatening interrogator and her gentler, more understanding colleague. It’s a fictional device that I’m reminded of often when I observe senior executives leading their teams in making important decisions in difficult situations. Some of them talk of ‘banging heads together’ while others talk of ‘putting our heads together’. Their words and their style set the emotional thermostat for their team’s discussions: pressured and compelled or relaxed and reflective. And that emotional temperature visibly shapes how the team makes its decisions. I’ll come back to which works best in a moment, but it’ll make more sense if I give you a brief taste of the science beneath my real-world observations.
There’s a wealth of research about how evolution has installed cognitive software in humans that allows us to understand and change the world better than, for example, our primate cousins. One particularly interesting finding is that we have a cognitive bias for integrating multiple perspectives and their implications. Anthropologists argue that this capacity for ‘Integrative Complexity’ (IC) was selected for during millennia of living in tribal societies. And it’s their little joke that the abbreviation echoes its meaning. But the most interesting part of this research is that our IC is affected by emotional temperature.
When we’re relatively relaxed and don’t feel threatened, we listen to others’ perspectives, understand them better and (this is the important bit) weave them together to get a richer, more accurate view of reality. And, of course, it’s that high-fidelity view of the world that enables better decision-making.
By contrast, emotionally pressured situations degrade our capacity for integrative complexity. We oversimplify or caricature perspectives other than our own and elevate our differences over our agreements. This leads to a less nuanced and less useful appreciation of what is going on around us. No prizes for guessing what that means for the quality of our decision-making. In short, we have an evolved ability to see the world in all its complexity and make accordingly wise decisions. But we’ve also evolved to make quick, easy and less wise decisions when we feel pressured.
This evolutionary anthropology stuff is fascinating, but let’s talk about you, your team and perhaps your boss. I have a lot of sympathy for the ‘banging heads together’ style. Without some amount of compulsion, teams have unlimited ability to waffle, prevaricate and dither. On the other hand, set the room temperature too high and the team’s cognitive software will switch from integrative complexity to quick, easy and wrong. And this explains a lot of what I see when I watch life sciences companies make difficult, multifactorial decisions.
Dithering and fudging happen when the room temperature is so relaxed that no one feels like moving. Bad decisions can be traced to a simplistic, inaccurate understanding of the situation that results from quick and easy judgments made when leaders put the pressure on. The best decisions are built on a wise appreciation of the situation that only happens in the ‘Goldilocks’ zone, where pressure to act and integration of different perspectives are ‘just right’.