- Design
- Post hoc analysis of phase 3 trials and long-term extension
- Population
- Adolescents and adults with moderate-to-severe atopic dermatitis; week-16 responders for long-term data
- Primary outcome
- Head-and-neck EASI responses and facial IGA
- Effect
- Week 152: HN EASI-75 maintained in 94.8%; HN EASI ≤1 in 93.8%
A post hoc analysis pooled lebrikizumab phase 3 trials and their long-term extension in adolescents and adults with moderate-to-severe atopic dermatitis, looking specifically at head, neck and face disease, which is hard to treat and visible.
Among patients who had responded by week 16 and continued 250 mg every four weeks, 94.8% kept head-and-neck EASI-75, 82.9% EASI-90 and 85.3% EASI-100 at week 152. At three years, 93.8% had a head-and-neck EASI of 1 or less. In a trial in patients with skin of colour, 61% reached clear facial skin at week 24; in patients previously treated with dupilumab, 55%.
The main limitation is that the long-term figures apply only to early responders who stayed on treatment, which flatters durability. It is still useful for counselling patients who respond well: the face tends to stay clear on monthly maintenance.
- Patients who respond to lebrikizumab by week 16 are likely to keep facial and neck clearance over three years.
- Monthly maintenance dosing was used in the long-term data.
- About half of patients previously on dupilumab reached clear facial skin at week 24.
- Persistent facial eczema on a biologic should prompt a check for contact allergy or a drug-related facial erythema.
Why it matters
Facial eczema drives much of the quality-of-life burden, and durability on monthly dosing matters to patients choosing a biologic.
Don't overread it
The three-year figures are from week-16 responders only, so they overstate durability across all treated patients.
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