Anchored Matching-Adjusted Indirect Comparison of the Long-Term Maintenance of Efficacy of Tralokinumab and Lebrikizumab in Patients with Moderate-to-Severe Atopic Dermatitis

Document Type

Journal Article

Publication Date

10-23-2025

Journal

Dermatology and therapy

DOI

10.1007/s13555-025-01563-3

Keywords

Atopic dermatitis; Lebrikizumab; Long-term disease management; Maintenance of efficacy; Matching-adjusted indirect comparison; Tralokinumab

Abstract

INTRODUCTION: Atopic dermatitis (AD) is a chronic skin disease largely driven by interleukin (IL)-13, which is targeted by tralokinumab and lebrikizumab. Effective, long-term treatments are needed, and head-to-head studies comparing these available therapeutics have yet to be conducted. This analysis indirectly compared the maintenance of efficacy of tralokinumab and lebrikizumab at week 52 in week-16 responders. METHODS: An anchored matching-adjusted indirect comparison was performed using individual patient data (IPD) from the ECZTRA 1 and ECZTRA 2 tralokinumab trials and aggregate data from the ADvocate 1 and ADvocate 2 lebrikizumab trials, with IPD weighted to match ADvocate baseline and week-16 characteristics. Week-16 responders, patients achieving 75% reduction in Eczema Area and Severity Index (EASI-75) or Investigator Global Assessment 0 or 1 (IGA 0/1) with an ≥ 2-point improvement from baseline, were re-randomized to active treatment every 2 weeks (Q2W), every 4 weeks (Q4W), or placebo Q2W for the 36-week maintenance period. Week 52 efficacy outcomes included IGA 0/1, EASI-75, 90% reduction in EASI (EASI-90), EASI percentage improvement, and pruritus numerical rating scale 4-point improvement (pruritus 4pt) from baseline. Response differences relative to placebo for endpoints of interest were calculated between tralokinumab and lebrikizumab for Q2W and Q4W dosing to compare maintenance of efficacy at week 52 among week 16-responders. RESULTS: Differences in efficacy endpoints between tralokinumab and lebrikizumab were not statistically significant; within Q2W dosing, tralokinumab versus lebrikizumab response rate differences at week 52 numerically favored tralokinumab (IGA 0/1: 1.2%, EASI-75: 19.8%, EASI-90: 1.5%, EASI percentage improvement from baseline: 3.3%, pruritus 4pt: 17.6%) while Q4W differences were more variable (IGA 0/1: -20.5%, EASI-75: 15.7%, EASI-90: -8.5%, EASI percentage improvement from baseline: -0.5%, pruritus 4pt: -2.7%). CONCLUSIONS: Comparable maintenance of efficacy was observed between tralokinumab and lebrikizumab after 52 weeks of treatment among patients meeting response criteria at week 16.

Department

Dermatology

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