Skip to main content
Top
Published in: Dermatology and Therapy 5/2024

Open Access 03-05-2024 | Atopic Dermatitis | Original Research

Lebrikizumab Provides Rapid Clinical Responses Across All Eczema Area and Severity Index Body Regions and Clinical Signs in Adolescents and Adults with Moderate-to-Severe Atopic Dermatitis

Authors: Eric L. Simpson, Marjolein de Bruin-Weller, H. Chih-ho Hong, Delphine Staumont-Sallé, Andrew Blauvelt, Kilian Eyerich, Melinda Gooderham, Mona Shahriari, Lotus Mallbris, Amber Reck Atwater, Maria Jose Rueda, Yuxin Ding, Zhuqing Liu, Helena Agell, Jonathan I. Silverberg

Published in: Dermatology and Therapy | Issue 5/2024

Login to get access

Abstract

Introduction

Atopic dermatitis (AD) affects multiple areas of the body, some of which may be more refractory to treatment. We evaluated improvements in the Eczema Area and Severity Index (EASI) by body region and clinical signs for each body region in lebrikizumab-treated patients with moderate-to-severe AD.

Methods

ADvocate 1 and ADvocate 2 compared lebrikizumab 250 mg as monotherapy every 2 weeks versus placebo for 16 weeks. Efficacy measures included EASI, which rates the extent and severity of four clinical signs (erythema, edema/papulation, excoriation, lichenification) in four body regions (head/neck, upper extremities, trunk, lower extremities). Analyses are post hoc.

Results

Mean baseline EASI, body region EASI subscores, and the severity of clinical signs were consistent across both studies (EASI ranging from 16.0 to 72.0). At week 16 in both studies, patients treated with lebrikizumab showed significantly greater percent improvement in EASI across all body regions versus placebo (p ≤ 0.001), with improvements as early as week 2. In ADvocate 1, all clinical signs significantly improved across all body regions at week 16 with lebrikizumab (51.4–71.6% improvement) versus placebo (23.1–43.5%, p ≤ 0.001), with significant improvements as early as week 2 for all signs. Significant improvements for all clinical signs at week 16 were also seen in ADvocate 2 for lebrikizumab (53.5–75.6%) versus placebo (28.5–41.2%, p ≤ 0.001) and as early as week 2 for all body regions and signs except head/neck erythema and lower extremity erythema, edema/papulation, and lichenification, which showed significant improvement by week 4.

Conclusions

Lebrikizumab as monotherapy consistently and rapidly reduced the extent of involvement and severity of AD in all EASI clinical signs and body regions, including the head and neck region and clinical sign of lichenification, compared with placebo.

Trial Registration

ClinicalTrials.gov identifier: ADvocate 1 (NCT04146363) and ADvocate 2 (NCT04178967).
Literature
1.
go back to reference Lio PA, Wollenberg A, Thyssen JP, et al. Impact of atopic dermatitis lesion location on quality of life in adult patients in a real-world study. J Drugs Dermatol. 2020;19(10):943–8.CrossRefPubMed Lio PA, Wollenberg A, Thyssen JP, et al. Impact of atopic dermatitis lesion location on quality of life in adult patients in a real-world study. J Drugs Dermatol. 2020;19(10):943–8.CrossRefPubMed
2.
go back to reference Hajar T, Leshem YA, Hanifin JM, The National Eczema Association Task Force, et al. A systematic review of topical corticosteroid withdrawal (“steroid addiction”) in patients with atopic dermatitis and other dermatoses. J Am Acad Dermatol. 2015;72(3):541-9.e2.CrossRefPubMed Hajar T, Leshem YA, Hanifin JM, The National Eczema Association Task Force, et al. A systematic review of topical corticosteroid withdrawal (“steroid addiction”) in patients with atopic dermatitis and other dermatoses. J Am Acad Dermatol. 2015;72(3):541-9.e2.CrossRefPubMed
3.
go back to reference Simpson EL, Lacour JP, Spelman L, et al. Baricitinib in patients with moderate-to-severe atopic dermatitis and inadequate response to topical corticosteroids: results from two randomized monotherapy phase III trials. Br J Dermatol. 2020;183(2):242–55.CrossRefPubMed Simpson EL, Lacour JP, Spelman L, et al. Baricitinib in patients with moderate-to-severe atopic dermatitis and inadequate response to topical corticosteroids: results from two randomized monotherapy phase III trials. Br J Dermatol. 2020;183(2):242–55.CrossRefPubMed
4.
go back to reference Simpson EL, Bieber T, Guttman-Yassky E, et al. Two phase 3 trials of dupilumab versus placebo in atopic dermatitis. N Engl J Med. 2016;375(24):2335–48.CrossRefPubMed Simpson EL, Bieber T, Guttman-Yassky E, et al. Two phase 3 trials of dupilumab versus placebo in atopic dermatitis. N Engl J Med. 2016;375(24):2335–48.CrossRefPubMed
5.
go back to reference Silverberg JI, Toth D, Bieber T, et al. Tralokinumab plus topical corticosteroids for the treatment of moderate-to-severe atopic dermatitis: results from the double-blind, randomized, multicentre, placebo-controlled phase III ECZTRA 3 trial. Br J Dermatol. 2021;184(3):450–63.CrossRefPubMedPubMedCentral Silverberg JI, Toth D, Bieber T, et al. Tralokinumab plus topical corticosteroids for the treatment of moderate-to-severe atopic dermatitis: results from the double-blind, randomized, multicentre, placebo-controlled phase III ECZTRA 3 trial. Br J Dermatol. 2021;184(3):450–63.CrossRefPubMedPubMedCentral
6.
go back to reference Blauvelt A, Rosmarin D, Bieber T, et al. Improvement of atopic dermatitis with dupilumab occurs equally well across different anatomical regions: data from phase III clinical trials. Br J Dermatol. 2019;181(1):196–7.CrossRefPubMedPubMedCentral Blauvelt A, Rosmarin D, Bieber T, et al. Improvement of atopic dermatitis with dupilumab occurs equally well across different anatomical regions: data from phase III clinical trials. Br J Dermatol. 2019;181(1):196–7.CrossRefPubMedPubMedCentral
7.
go back to reference Simpson EL, Paller AS, Siegfried EC, et al. Dupilumab demonstrates rapid and consistent improvement in extent and signs of atopic dermatitis across all anatomical regions in pediatric patients 6 years of age and older. Dermatol Ther (Heidelb). 2021;11(5):1643–56.PubMed Simpson EL, Paller AS, Siegfried EC, et al. Dupilumab demonstrates rapid and consistent improvement in extent and signs of atopic dermatitis across all anatomical regions in pediatric patients 6 years of age and older. Dermatol Ther (Heidelb). 2021;11(5):1643–56.PubMed
8.
go back to reference Alexis A, de Bruin-Weller M, Weidinger S, et al. Rapidity of improvement in signs/symptoms of moderate-to-severe atopic dermatitis by body region with abrocitinib in the phase 3 JADE COMPARE study. Dermatol Ther (Heidelb). 2022;12(3):771–85.CrossRefPubMed Alexis A, de Bruin-Weller M, Weidinger S, et al. Rapidity of improvement in signs/symptoms of moderate-to-severe atopic dermatitis by body region with abrocitinib in the phase 3 JADE COMPARE study. Dermatol Ther (Heidelb). 2022;12(3):771–85.CrossRefPubMed
9.
go back to reference Ratnarajah K, Le M, Muntyanu A, et al. Inhibition of IL-13: a new pathway for atopic dermatitis. J Cutan Med Surg. 2021;25(3):315–28.CrossRefPubMed Ratnarajah K, Le M, Muntyanu A, et al. Inhibition of IL-13: a new pathway for atopic dermatitis. J Cutan Med Surg. 2021;25(3):315–28.CrossRefPubMed
10.
go back to reference Bieber T. Interleukin-13: targeting an underestimated cytokine in atopic dermatitis. Allergy. 2020;75:54–62.CrossRefPubMed Bieber T. Interleukin-13: targeting an underestimated cytokine in atopic dermatitis. Allergy. 2020;75:54–62.CrossRefPubMed
11.
go back to reference Tsoi LC, Rodriguez E, Degenhardt F, et al. Atopic dermatitis is an IL-13-dominant disease with greater molecular heterogeneity compared to psoriasis. J Invest Dermatol. 2019;139(7):1480–9.CrossRefPubMedPubMedCentral Tsoi LC, Rodriguez E, Degenhardt F, et al. Atopic dermatitis is an IL-13-dominant disease with greater molecular heterogeneity compared to psoriasis. J Invest Dermatol. 2019;139(7):1480–9.CrossRefPubMedPubMedCentral
12.
go back to reference Okragly A, Ryuzoji A, Daniels M, Patel C, Benschop R. Comparison of the affinity and in vitro activity of lebrikizumab, tralokinumab, and cendakimab. Exp Dermatol. 2021;30(Suppl 1):3–43. Okragly A, Ryuzoji A, Daniels M, Patel C, Benschop R. Comparison of the affinity and in vitro activity of lebrikizumab, tralokinumab, and cendakimab. Exp Dermatol. 2021;30(Suppl 1):3–43.
13.
go back to reference Guttman-Yassky E, Blauvelt A, Eichenfield LF, et al. Efficacy and safety of lebrikizumab, a high-affinity interleukin 13 inhibitor, in adults with moderate to severe atopic dermatitis: a phase 2b randomized clinical trial. JAMA Dermatol. 2020;156(4):411–20.CrossRefPubMedPubMedCentral Guttman-Yassky E, Blauvelt A, Eichenfield LF, et al. Efficacy and safety of lebrikizumab, a high-affinity interleukin 13 inhibitor, in adults with moderate to severe atopic dermatitis: a phase 2b randomized clinical trial. JAMA Dermatol. 2020;156(4):411–20.CrossRefPubMedPubMedCentral
14.
go back to reference Simpson EL, Gooderham M, Wollenberg A, et al. Efficacy and safety of lebrikizumab in combination with topical corticosteroids in adolescents and adults with moderate-to-severe atopic dermatitis: a randomized clinical trial (ADhere). JAMA Dermatol. 2023;159(2):182–91.CrossRefPubMedPubMedCentral Simpson EL, Gooderham M, Wollenberg A, et al. Efficacy and safety of lebrikizumab in combination with topical corticosteroids in adolescents and adults with moderate-to-severe atopic dermatitis: a randomized clinical trial (ADhere). JAMA Dermatol. 2023;159(2):182–91.CrossRefPubMedPubMedCentral
15.
go back to reference Silverberg JI, Guttman-Yassky E, Thaçi D, et al. Two phase 3 trials of lebrikizumab for moderate-to-severe atopic dermatitis. N Engl J Med. 2023;388:1080–91.CrossRefPubMed Silverberg JI, Guttman-Yassky E, Thaçi D, et al. Two phase 3 trials of lebrikizumab for moderate-to-severe atopic dermatitis. N Engl J Med. 2023;388:1080–91.CrossRefPubMed
16.
go back to reference Blauvelt A, Thyssen JP, Guttman-Yassky E, et al. Efficacy and safety of lebrikizumab in moderate-to-severe atopic dermatitis: 52-week results of two randomized double-blinded placebo-controlled phase III trials. Br J Dermatol. 2023;188(6):740–8.CrossRefPubMed Blauvelt A, Thyssen JP, Guttman-Yassky E, et al. Efficacy and safety of lebrikizumab in moderate-to-severe atopic dermatitis: 52-week results of two randomized double-blinded placebo-controlled phase III trials. Br J Dermatol. 2023;188(6):740–8.CrossRefPubMed
17.
go back to reference Hanifin JM, Thurston M, Omoto TM, Cherill R, Tofte SJ, Graeber M, EASI Evaluator Group. The eczema area and severity index (EASI): assessment of reliability in atopic dermatitis. Exp Dermatol. 2001;10(1):11–8.CrossRefPubMed Hanifin JM, Thurston M, Omoto TM, Cherill R, Tofte SJ, Graeber M, EASI Evaluator Group. The eczema area and severity index (EASI): assessment of reliability in atopic dermatitis. Exp Dermatol. 2001;10(1):11–8.CrossRefPubMed
18.
go back to reference Hanifin JM, Baghoomian W, Grinich E, Leshem YA, Jacobson M, Simpson EL. The eczema area and severity index-a practical guide. Dermatitis. 2022;33(3):187–92.CrossRefPubMedPubMedCentral Hanifin JM, Baghoomian W, Grinich E, Leshem YA, Jacobson M, Simpson EL. The eczema area and severity index-a practical guide. Dermatitis. 2022;33(3):187–92.CrossRefPubMedPubMedCentral
19.
go back to reference Ribero S, Puglisi B, Giura MT, et al. Head and neck severity index is associated to a significant worsening of quality of life in atopic dermatitis patients. Exp Dermatol. 2021;30(11):1717–8.CrossRefPubMed Ribero S, Puglisi B, Giura MT, et al. Head and neck severity index is associated to a significant worsening of quality of life in atopic dermatitis patients. Exp Dermatol. 2021;30(11):1717–8.CrossRefPubMed
20.
go back to reference Beikert FC, Langenbruch AK, Radtke MA, Kornek T, Purwins S, Augustin M. Willingness to pay and quality of life in patients with atopic dermatitis. Arch Dermatol Res. 2014;306(3):279–86.CrossRefPubMed Beikert FC, Langenbruch AK, Radtke MA, Kornek T, Purwins S, Augustin M. Willingness to pay and quality of life in patients with atopic dermatitis. Arch Dermatol Res. 2014;306(3):279–86.CrossRefPubMed
21.
go back to reference Wollenberg A, Christen-Zäch S, Taieb A, et al. ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children. J Eur Acad Dermatol Venereol. 2020;34(12):2717–44.CrossRefPubMed Wollenberg A, Christen-Zäch S, Taieb A, et al. ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children. J Eur Acad Dermatol Venereol. 2020;34(12):2717–44.CrossRefPubMed
22.
go back to reference Jo CE, Finstad A, Georgakopoulos JR, Piguet V, Yeung J, Drucker AM. Facial and neck erythema associated with dupilumab treatment: a systematic review. J Am Acad Dermatol. 2021;84(5):1339–47.CrossRefPubMed Jo CE, Finstad A, Georgakopoulos JR, Piguet V, Yeung J, Drucker AM. Facial and neck erythema associated with dupilumab treatment: a systematic review. J Am Acad Dermatol. 2021;84(5):1339–47.CrossRefPubMed
23.
go back to reference de Wijs LEM, Nguyen NT, Kunkeler ACM, et al. Clinical and histopathological characterization of paradoxical head and neck erythema in patients with atopic dermatitis treated with dupilumab: a case series. Br J Dermatol. 2020;183(4):745–9.CrossRefPubMed de Wijs LEM, Nguyen NT, Kunkeler ACM, et al. Clinical and histopathological characterization of paradoxical head and neck erythema in patients with atopic dermatitis treated with dupilumab: a case series. Br J Dermatol. 2020;183(4):745–9.CrossRefPubMed
24.
go back to reference Murase J, Munera M, Hong C, et al. Lebrikizumab-treated patients with atopic dermatitis had no increase in treatment-emergent adverse events of facial, head, and neck erythema compared to placebo. SKIN J Cutan Med. 2023;7(6): s272.CrossRef Murase J, Munera M, Hong C, et al. Lebrikizumab-treated patients with atopic dermatitis had no increase in treatment-emergent adverse events of facial, head, and neck erythema compared to placebo. SKIN J Cutan Med. 2023;7(6): s272.CrossRef
25.
go back to reference Silverberg JI, Shi VY, Alexis A, et al. Racial and ethnic differences in sociodemographic, clinical, and treatment characteristics among patients with atopic dermatitis in the United States and Canada: real-world data from the CorEvitas atopic dermatitis registry. Dermatol Ther (Heidelb). 2023;13(9):2045–61.CrossRefPubMed Silverberg JI, Shi VY, Alexis A, et al. Racial and ethnic differences in sociodemographic, clinical, and treatment characteristics among patients with atopic dermatitis in the United States and Canada: real-world data from the CorEvitas atopic dermatitis registry. Dermatol Ther (Heidelb). 2023;13(9):2045–61.CrossRefPubMed
Metadata
Title
Lebrikizumab Provides Rapid Clinical Responses Across All Eczema Area and Severity Index Body Regions and Clinical Signs in Adolescents and Adults with Moderate-to-Severe Atopic Dermatitis
Authors
Eric L. Simpson
Marjolein de Bruin-Weller
H. Chih-ho Hong
Delphine Staumont-Sallé
Andrew Blauvelt
Kilian Eyerich
Melinda Gooderham
Mona Shahriari
Lotus Mallbris
Amber Reck Atwater
Maria Jose Rueda
Yuxin Ding
Zhuqing Liu
Helena Agell
Jonathan I. Silverberg
Publication date
03-05-2024
Publisher
Springer Healthcare
Published in
Dermatology and Therapy / Issue 5/2024
Print ISSN: 2193-8210
Electronic ISSN: 2190-9172
DOI
https://doi.org/10.1007/s13555-024-01158-4

Other articles of this Issue 5/2024

Dermatology and Therapy 5/2024 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.