Lebrikizumab Improves Clinical Manifestations, Symptoms, and Quality of Life in Patients with Moderate-to-Severe Atopic Dermatitis Previously Treated with Dupilumab: Results from the ADapt Study

Authors

Jonathan I. Silverberg, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave NW 2Nd Floor, Washington, DC, 20037, USA. jonathanisilverberg@gmail.com.
Lindsay Ackerman, U.S. Dermatology Partners, Phoenix, AZ, USA.
Jerry Bagel, Eczema Treatment Center of Central New Jersey, East Windsor, NJ, USA.
Linda Stein Gold, Department of Dermatology, Henry Ford Hospital, Detroit, MI, USA.
Andrew Blauvelt, Blauvelt Consulting, LLC, Annapolis, MD, USA.
David Rosmarin, Indiana University School of Medicine, Indianapolis, IN, USA.
Raj Chovatiya, Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
Matthew Zirwas, DOCS Dermatology, Baxley, OH, USA.
Gil Yosipovitch, University of Miami Miller School of Medicine, Miami, FL, USA.
Jill Waibel, Miami Dermatology and Laser Institute, Miami, FL, USA.
Jenny E. Murase, University of California, San Francisco, CA, USA.
Ben Lockshin, DermAssociates, Silver Spring, MD, USA.
Jamie Weisman, Medical Dermatology Specialists, Atlanta, GA, USA.
Amber Reck Atwater, Eli Lilly and Company, Indianapolis, IN, USA.
Jennifer Proper, Eli Lilly and Company, Indianapolis, IN, USA.
Maria Silk, Eli Lilly and Company, Indianapolis, IN, USA.
Evangeline Pierce, Eli Lilly and Company, Indianapolis, IN, USA.
Maria Lucia Piruzeli, Eli Lilly and Company, Indianapolis, IN, USA.
Sonia Montmayeur, Eli Lilly and Company, Indianapolis, IN, USA.
Christopher Schuster, Eli Lilly and Company, Indianapolis, IN, USA.
Jinglin Zhong, IQVIA, Durham, NC, USA.
Maria Jose Rueda, Eli Lilly and Company, Indianapolis, IN, USA.
Sreekumar Pillai, Eli Lilly and Company, Indianapolis, IN, USA.
Eric Simpson, Oregon Health & Science University, Portland, OR, USA.

Document Type

Journal Article

Publication Date

1-19-2026

Journal

Dermatology and therapy

DOI

10.1007/s13555-025-01644-3

Keywords

Atopic dermatitis; Dupilumab-experienced; Itch relief; Lebrikizumab; Skin clearance

Abstract

INTRODUCTION: Patients with moderate-to-severe atopic dermatitis (AD) who discontinue dupilumab need additional therapeutic options. Lebrikizumab's distinct mechanism of action may provide that alternative treatment. We evaluated efficacy and safety of lebrikizumab in adults and adolescents with moderate-to-severe AD previously treated with dupilumab. METHODS: In the open-label ADapt trial, patients who discontinued dupilumab due to inadequate response, adverse events (AEs)/intolerance, or other reasons received lebrikizumab 250-mg every 2 weeks (Q2W) following 500-mg loading dose at baseline/week 2, through week 16, with optional topical therapy. From weeks 16-24, responders (≥ 75% improvement in Eczema Area and Severity Index [EASI 75] or Investigator's Global Assessment score 0/1 with ≥ 2-point improvement from baseline) received lebrikizumab every 4 weeks; inadequate responders continued lebrikizumab Q2W. The primary endpoint was EASI 75 at week 16 in the intent-to-treat population; EASI 75 was also analyzed by reason for dupilumab discontinuation. Secondary and exploratory efficacy endpoints were assessed throughout. RESULTS: Among the 86 patients enrolled, primary reasons for stopping dupilumab were inadequate response (n = 48, 55.8%), AEs/intolerance (n = 14, 16.3%), and other reasons (n = 24, 27.9%). Fifty-nine patients (68.6%) completed week 16; 52 patients (60.5%) completed week 24. At weeks 16 and 24, respectively, response rates were 57.4% (35/61) and 60.0% (33/55) for EASI 75; 53.2% (25/47) and 61.5% (24/39) for Pruritus Numeric Rating Scale ≥ 4-point improvement; and 83.0% (44/53) and 83.0% (39/47) for Dermatology Life Quality Index ≥ 4-point improvement. Most treatment-emergent AEs were mild/moderate. Serious AEs and discontinuations due to AEs were reported by 2 (2.3%) and 5 (5.8%) patients, respectively. Of the 10 patients who discontinued dupilumab due to eye-related events, facial dermatitis, or inflammatory arthritis, none reported similar events with lebrikizumab. CONCLUSION: Results suggest that lebrikizumab provides meaningful improvements in skin clearance, itch, and quality of life in dupilumab-experienced patients with moderate-to-severe AD, with a safety profile consistent with other lebrikizumab phase 3 trials. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT05369403.

Department

Dermatology

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