5-Year ADlong Data on Lebrikizumab for Eczema, With Stephan Weidinger, MD, PhD

Late-breaking results from the phase 3b ADlong open-label extension (NCT05916365), presented by Almirall at the 2026 European Academy of Dermatology and Venereology (EADV) Congress in Vienna, Austria, showed sustained improvements in skin signs and itch at Week 108 in patients with moderate-to-severe atopic dermatitis.1,2,3

The study enrolled 174 adults and adolescents in Germany and Poland who had completed the ADjoin long-term extension, representing up to 5 years of cumulative lebrikizumab exposure.2,3 At the 108-week mark, 92.9% of subjects achieved EASI-75, 73.8% attained EASI-90, 66.7% reached clear or almost-clear skin, and 78.0% saw a Pruritus NRS score of 4 or less, with no new safety signals identified.

The findings extend 4-year interim ADlong data presented earlier in 2026 and reflect Almirall’s broader commitment to medical dermatology, the exclusive focus of its research and development efforts and pipeline. In the following Q&A, Stephan Weidinger, MD, PhD, professor and chair of dermatology at Christian-Albrechts-University of Kiel and director of the Department of Dermatology and Allergy at University Hospital Schleswig-Holstein, discusses the 5-year results:

HCPLive: What are the key takeaways from the 5-year ADlong data on lebrikizumab in moderate-to-severe atopic dermatitis, and what do they add to the earlier 4-year interim findings?

Stephan Weidinger, MD, PhD: For me, the main message is the consistency of the data over time. The 4-year interim analysis had already shown that disease control with lebrikizumab could be maintained long term. The 5-year data now extend this observation by another year and show that high levels of skin response and itch control remain largely stable, without emergence of new safety signals.

I also find it important that most patients were treated with lebrikizumab every four weeks and that the majority did not require rescue treatment or dose intensification. This suggests that, in patients who achieve and maintain a good response, durable disease control with a relatively low treatment burden is possible.

Of course, when interpreting long-term open-label extension studies, we have to take into account a certain degree of selection bias. Patients who continue into and remain in a long-term extension study are not fully representative of all patients starting treatment, and patients doing well are more likely to remain on therapy. Nevertheless, the stability of the responses over such a long period is very reassuring.

HCPLive: At Week 108, 92.9% of patients achieved EASI-75, 73.8% achieved EASI-90, and 66.7% reached clear or almost-clear skin. Which of these findings stood out most to you, and what do they suggest about the durability of response to IL-13 inhibition over time?

Stephan Weidinger, MD, PhD: I would probably focus less on one individual result and more on the overall stability of the responses. However, the EASI-90 result is particularly relevant to me. Achieving EASI-75 is important, but today our treatment goals increasingly go beyond partial improvement. The fact that almost three quarters of patients achieved EASI-90 at Week 108 indicates that a high level of skin clearance can be maintained over several years.

Equally important is that the response curves remained relatively stable rather than indicating a loss of efficacy. Again, we have to keep in mind that there is some selection over time in a long-term extension study, as patients who remain in the study to some extent are a selected population. But even taking this into account, I think these are very convincing long-term results and support the concept that selective inhibition of IL-13 can provide durable control of atopic dermatitis in patients who respond to treatment.

HCPLive: Itch is one of the most burdensome symptoms for patients with atopic dermatitis. How meaningful is it that 78.0% of patients reported a Pruritus NRS score of 4 or less after this length of treatment?

Stephan Weidinger, MD, PhD: I think this is clinically very meaningful. Itch is the symptom that affects patients most directly, including sleep, concentration and overall quality of life. Therefore, sustained control of itch is at least as important as improvement in visible skin lesions.

What I find reassuring is that itch control was maintained over a very long treatment period. A Pruritus NRS of 4 or less does not mean that every patient is completely free of itch, but it indicates that for a large majority the symptom burden remained substantially controlled. We also saw that around one third of patients reached an NRS of 0 or 1, which represents almost complete or complete absence of itch.

HCPLive: No new safety signals were identified, and most patients did not require topical or systemic rescue therapy. How might these long-term safety data shape conversations with patients considering a biologic as a multiyear maintenance therapy?

Stephan Weidinger, MD, PhD: Long-term safety is a very important topic when we discuss systemic treatment with patients, because atopic dermatitis is a chronic disease and treatment may be required for many years.

The reassuring aspect of these data is not only that no new safety signal emerged, but also that treatment discontinuations due to adverse events were uncommon. This gives us additional information beyond the shorter registration trials and helps us to discuss long-term treatment with more confidence.

Another important aspect is the reduction in overall treatment burden. Most patients did not require additional rescue medication, and in particular the need for anti-inflammatory topical treatment was relatively low. This is something many patients appreciate very much. Patients with moderate-to-severe atopic dermatitis have often spent years applying topical corticosteroids or other anti-inflammatory topical treatmentsover large areas of skin. If a biologic allows them to reduce this substantially, this represents an important practical benefit in everyday life, in addition to controlling the disease itself.

Of course, no long-term extension study can exclude rare adverse events, and continued pharmacovigilance and real-world data remain important.

HCPLive: What questions about long-term atopic dermatitis management remain unanswered, and where should future research on lebrikizumab focus next, such as dosing intervals, specific patient subgroups, or real-world outcomes?

Stephan Weidinger, MD, PhD: There are still several important questions. One is how far treatment can be individualised once stable disease control has been achieved. For example, which patients can remain well controlled with longer dosing intervals, and can we identify them prospectively?

A second area is patient heterogeneity. Atopic dermatitis is biologically and clinically very heterogeneous, and it will be important to understand whether particular phenotypes or molecular endotypes have especially durable responses to IL-13 inhibition.

Finally, we need more real-world evidence. Clinical trials provide very clean efficacy and safety data, but in routine practice patients have different comorbidities, adherence patterns and previous treatments. Long-term registries will therefore be important to understand treatment persistence, effectiveness, safety and optimal sequencing in everyday clinical care.

Editor’s Note: This transcript has been edited for grammar and clarity using artificial intelligence tools. Relevant financial disclosures for Weidinger include AbbVie, Almirall, Galderma, Kymab, LEO Pharma, Eli Lilly and Company, Pfizer, Regeneron, La Roche Posay, and Sanofi.

1. Weidinger S, Irvine AD, Thaçi D, et al. Lebrikizumab showed sustained efficacy and safety through 5 years in patients with moderate-to-severe atopic dermatitis: results from the ADlong long-term extension trial. Abstract LB-313. Presented at: European Academy of Dermatology and Venereology Congress 2026; September 30-October 3, 2026; Vienna, Austria.

2. Almirall. EADV 2026: long-term disease control for up to five years in patients with moderate-to-severe atopic dermatitis treated with lebrikizumab. News release. Business Wire. September 30, 2026. Accessed October 19, 2026. https://www.businesswire.com/news/home/20260930054188/en.

3. Almirall. EADV 2026: long-term disease control for up to five years in patients with moderate-to-severe atopic dermatitis treated with lebrikizumab. News release. October 1, 2026. Accessed October 19, 2026. https://www.almirall.com/news-media/newsroom/eadv-2026-long-term-disease-control-five-years-patients-moderate-severe-atopic.