Can lebrikizumab maintain response rates in atopic dermatitis?

Durable responses were observed for patients with moderate-to-severe atopic dermatitis (AD) who responded to lebrikizumab induction therapy, irrespective of concomitant use of topical corticosteroids, in an analysis of 3 phase 3 trials.

Prof. Emma Guttman-Yassky (Icahn School of Medicine at Mount Sinai, NY, USA) and co-investigators aimed to assess the maintenance of efficacy and the safety of lebrikizumab in patients with moderate-to-severe AD by analysing responders from the ADvocate 1 (NCT04146363) and ADvocate 2 trials (NCT04178967) (n=281 in total), and the ADjoin trial (NCT04392154; n=86) [1]. The novel IL-13 inhibitor lebrikizumab has previously been demonstrated to alleviate signs and symptoms of adult and adolescent patients with AD after 16 weeks of therapy [2]. Here, the research team primarily looked at the Investigator Global Assessment (IGA) and Eczema Area and Severity Index (EASI)75 responses from week 16 to week 52 for the ADvocate trials and up to week 56 for the ADjoin trial.

In the ADvocate 1 and 2 trials, 71.2% and 76.8% of the participants maintained an IGA response of 0 or 1 (i.e. clear or almost clear skin) at week 52 for the 2-week dosing and 4-week dosing regimen, respectively, whereas the corresponding rate for those who were in the withdrawal condition after week 16 (n=60) was 47.9%. In the ADjoin trial, the IGA 0/1 rate was 96.8% in the 2-week dosing regimen and 78.4% in the 4-week dosing regimen. Similar maintenance trends were observed for the EASI75 responses: of the participants in the 2-week dosing groups who achieved EASI75 at the end of the induction period of the ADvocate 1 and 2 trials, 78.4% maintained this response at week 52. In the 4-week dosing group, 81.7% of the participants reached this endpoint. For the ADjoin trial, the corresponding rates were 85.8% for the 2-week dosing group and 81.2% for the 4-week dosing group. “IGA 0/1 and EASI75 response rates were maintained, regardless of topical corticosteroids use during the induction period,” commented Prof. Guttman-Yassky.

She further stated that the safety profile of lebrikizumab was consistent with previously reported data on this agent in patients with AD. Approximately 50% of the participants experienced at least 1 adverse event, which were mostly mild or moderate and did not lead to treatment discontinuations.

In summary, patients with moderate-to-severe AD who responded to lebrikizumab induction therapy displayed durable responses with maintenance therapy, regardless of the use of topical corticosteroids during induction. According to the authors, the response rates were comparable for the 2-week and 4-week dosing regimens.

1. Guttman-Yassky E, et al. Maintenance of efficacy and safety with lebrikizumab up to one year of treatment in patients with moderate-to-severe atopic dermatitis with or without topical corticosteroids. Late-breaker Session 5, WCD 2023, 3–8 July, Singapore.
2. Warren RB, et al. Br J Dermatol. 2023; 88(Suppl 4).