Lebrikizumab viable treatment alternative to JAK inhibitors in atopic dermatitis
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Key takeaways:
- Lebrikizumab will likely be a drug prescribers try ahead of Janus kinase inhibitors.
- Greater proportions of patients treated with lebrikizumab achieved IGA 0 or 1 and EASI 75 vs. placebo-treated patients.
NEW ORLEANS — Advancements in atopic dermatitis treatment have allowed prescribers and patients to choose between various options, according to a presenter at the American Academy of Dermatology Annual Meeting.
“This is an incredible time for atopic dermatitis,” Emma Guttman-Yassky, MD, PhD, the Waldman Professor and System Chair of the Kimberly and Eric J. Waldman Department of Dermatology at the Icahn School of Medicine at Mount Sinai, told Healio. “The expanding portfolio of biologic and small molecules for treating atopic dermatitis each offer unique features.”
While dupilumab has demonstrated efficacy in treating AD, some patients may want to avoid Janus kinase (JAK) inhibitors. During her presentation, Guttman-Yassky discussed which biologic options are available that also provide long-term maintenance, one of which is lebrikizumab (Lilly).
Lebrikizumab, an interleukin-13 inhibitor, has recently demonstrated efficacy in the ADvocate 1 and 2 phase 3 trials in which the drug met primary and coprimary endpoints after 52 weeks of treatment among patients with moderate to severe AD.
In the 52-week extension of ADvocate 1, 76% of patients treated with 250 mg of lebrikizumab once every 2 weeks and 74% of patients treated with 250 mg of lebrikizumab once every 4 weeks saw an IGA of 0 or 1 with at least a 2-point improvement compared with 47% of placebo-treated patients. Also, 79% of both lebrikizumab groups achieved EASI 75 compared with 61% of the placebo group.
The consistency of these outcomes was confirmed in ADvocate 2, with 81% of patients treated with lebrikizumab 250 mg every 4 weeks and 65% of those treated every 2 weeks achieving the IGA endpoint vs. 50% of placebo patients. Further, 85% of the treatment group receiving lebrikizumab every 4 weeks and 77% receiving the drug every 2 weeks achieved the EASI 75 endpoint compared with 72% of the placebo group.
However, safety data showed that conjunctivitis appeared to be a prevalent adverse event in both ADvocate 1 and 2 (14% and 15%, respectively).
For those worried about conjunctivitis, a 56-week efficacy study of tralokinumab, ECZTEND OLE, showed high levels of efficacy and a safety profile that was “encouraging, with rates of conjunctivitis lower than expected” at 8%, according to Guttman-Yassky.
Nevertheless, lebrikizumab will likely be added to the number of drugs prescribers try ahead of a JAK inhibitor, Guttman-Yassky said during her presentation.