Results from the phase 3b ADapt study presented at the recent Revolutionizing Atopic Dermatitis (RAD) Conference indicated lebrikizumab (LEB) improved skin clearance, reduced itch, and enhanced quality of life in patients with moderate-to-severe atopic dermatitis (AD) in whom dupilumab (DUPI) was discontinued.
The study included 86 patients with moderate-to-severe AD who had stopped DUPI treatment for reasons including loss of efficacy (56%), intolerance or adverse events (16%), and other factors (28%). Patients in the study received an initial 500-mg loading dose of LEB, followed by 250 mg every two weeks (Q2W) through week 16. Patients who responded were transferred to a once-monthly dose at week 16 as others continued with biweekly dosing.
At the week 24 timepoint, 60% of patients achieved EASI75 (≥75% improvement in Eczema Area and Severity Index) via as-observed analyses, 38.2% achieved an IGA score of 0/1 (clear/almost clear skin), and 61.5% reported a ≥4-point improvement in pruritus severity. Improvements in Dermatology Life Quality Index (DLQI) were seen in 83% of patients by week 24. Results were slightly lower in the nonresponder imputation analysis but demonstrated overall consistency. The safety profile was comparable to prior trials (3.5% of patients reported conjunctivitis, none of whom had discontinued DUPI due to conjunctivitis).
"In real-world AD clinical care, we may have to switch from one treatment type to another in order to optimize outcomes in patients who aren't achieving their efficacy goals or who may have particular adverse events or tolerability issues while on therapy," study co-author Raj Chovatiya, MD, PhD, a dermatologist and Clinical Associate Professor of Medicine at Rosalind Franklin University Chicago Medical School, told Practical Dermatology. "The ADapt trial was designed to specifically examine lebrikizumab outcomes among patients with dupilumab treatment experience, including past inadequate response. These findings show that lebrikizumab can be a treatment option for these patients and result in meaningful improvement in the signs and symptoms of AD."
Source: Haykal D, et al. Journal of Drugs in Dermatology. 2024. Doi:10.36849/JDD.8872