Key Takeaways:
- Most early nemolizumab responders reached EASI-90 by week 152.
- Half of early responders achieved completely clear skin at 3 years.
- Itch relief often comes before full lesion clearance with IL-31 blockade.
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3-Year Nemolizumab Data in Atopic Dermatitis, With Sarina Elmariah, MD, PhD
Sarina Berger Elmariah, MD, PhD, MPH, reviews 3-year nemolizumab data showing deeper skin clearance and lasting itch relief in atopic dermatitis responders.
Individuals living with moderate-to-severe atopic dermatitis who respond early to nemolizumab (Nemluvio; Galderma) tend to keep improving with continued treatment.
This finding comes from a post hoc analysis of the ARCADIA long-term extension presented at the 2026 Fall Clinical Dermatology Conference in Las Vegas, Nevada.¹ Sarina Berger Elmariah, MD, PhD, MPH, first author of the analysis and director of the UCSF Center of Excellence for Itch and Neurosensory Disorders, reviewed the findings with the editorial team at HCPLive.
Nemolizumab blocks the interleukin (IL)-31 receptor alpha. The replicate phase 3 ARCADIA 1 and ARCADIA 2 trials enrolled 1728 patients aged 12 years and older who were also using topical therapy. At week 16, more nemolizumab recipients than placebo recipients reached Investigator’s Global Assessment (IGA) 0/1 (36% and 38% vs 25% and 26%).²
What Did 3-Year Nemolizumab Data Show in Early Responders?
The new analysis followed 295 participants who met response criteria at the close of the 16-week pivotal phase, defined as IGA 0/1 or 75% improvement in Eczema Area and Severity Index (EASI-75). They stayed on every-4-week dosing through week 152. By then, about 4 in 5 had reached EASI-90, half had fully clear skin, and about 80% reported being itch-free or nearly itch-free.¹ Elmariah noted that lesion clearance in this group kept deepening instead of leveling off. Across the broader extension population of 1903 participants, up to 75% reached EASI-90, and up to 73% were itch-free or nearly itch-free.¹
Why Does IL-31 Blockade Matter for Itch-Driven Disease?
Elmariah described itch as the main reason patients with atopic dermatitis seek care, whatever their disease severity. Dermatologists have historically focused on controlling inflammation first and expected pruritus to improve afterward. With IL-31 blockade, itch relief tends to come first, and skin clearance may build over months. In practice, she said, an early response is a reassuring sign that the benefit will continue. Patients whose lesions improve slowly can still move toward near or complete clearance if they stay on therapy.
What Questions Remain About Long-Term Nemolizumab Use?
Elmariah called for mechanistic studies of what suppressing itch does biologically. It could quiet sensory nerves, interrupt inflammatory signaling, or change how immune, nerve, and skin cells communicate. The answers could show whether long-term agents support true remission, disease modification, or control of related comorbidities.
Editor’s Note: This transcript has been edited for grammar and clarity using artificial intelligence tools. Elmariah has previously disclosed receiving consultancy and advisory board honoraria from Bambusa Therapeutics, Celldex Therapeutics, Disk Medicine, Galderma, Genzyme, Incyte, Novartis, Pfizer, Regeneron, Sanofi, and ZenZema.
References
Galderma. Fall Clinical 2026: Galderma presents new three-year Nemluvio data showing deep and lasting skin lesion and itch responses in patients with atopic dermatitis aged 12 and older. Published October 8, 2026. Accessed October 23, 2026. https://www.galderma.com/news/fall-clinical-2026-galderma-presents-new-three-year-nemluvior-data-showing-deep-and-lasting.
Silverberg JI, Wollenberg A, Reich A, et al. Nemolizumab with concomitant topical therapy in adolescents and adults with moderate-to-severe atopic dermatitis (ARCADIA 1 and ARCADIA 2): results from two replicate, double-blind, randomised controlled phase 3 trials. Lancet. 2024;404(10451):445-460. doi:10.1016/S0140-6736(24)01203-0.
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