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Shawn Kwatra, MD, discusses ADtouch data showing lebrikizumab improved clearance, itch, pain, and satisfaction in hand and foot atopic dermatitis.
Lebrikizumab (Ebglyss) monotherapy significantly improved skin clearance, itch, pain, and patient satisfaction in adults and adolescents with moderate-to-severe hand and foot atopic dermatitis in the phase 3b ADtouch trial, according to late-breaking data presented at the European Academy of Dermatology and Venereology (EADV) Congress 2026 in Vienna, Austria.1,2
Shawn G. Kwatra, MD, Joseph W. Burnett Endowed Professor and Chair in Dermatology and Chief of Service, Dermatology, at the University of Maryland School of Medicine and University of Maryland Medical Center, discussed the findings with HCPLive.
ADtouch (NCT06921759) was a randomized, double-blind, placebo-controlled trial evaluating lebrikizumab 250 mg every 2 weeks vs placebo for 16 weeks in 221 patients with moderate-to-severe hand and foot atopic dermatitis and an inadequate response to topical therapy. Most enrolled patients had limited disease elsewhere on the body.
Kwatra described the trial’s broader significance as reinforcing the idea disease burden is not defined by body surface area alone. Hand and foot involvement represents a high-impact phenotype, he noted, in which pain, itch, sleep disruption, and difficulty working, walking, or performing daily tasks such as cooking can be substantial despite limited overall skin involvement.
He also emphasized treatment success should be multidimensional, encompassing skin clearance, rapid reductions in itch and pain, improved function and quality of life, and patient satisfaction with disease control, not improvement in investigator global assessment alone.
At Week 16, 53% of patients receiving lebrikizumab achieved clear or almost clear hands and feet (HF-IGA 0/1 with at least a 2-point improvement) vs 27% receiving placebo, the trial’s primary endpoint. A 4-point or greater improvement in hand and foot itch occurred in 57% vs 19% of patients, with significant itch improvement as early as Week 2, and a 4-point or greater improvement in hand and foot pain occurred in 59% vs 19%.
Kwatra highlighted the pain findings in particular, describing pain from fissured skin on the hands and feet as an important and underrecognized aspect of the disease. Among patients dissatisfied with hand clearance at baseline, 77% receiving lebrikizumab were satisfied or very satisfied at Week 16 vs 40% receiving placebo.
Safety was consistent with the established profile of lebrikizumab, with no new safety signals. Adverse events were mild or moderate, and discontinuations due to adverse events occurred in 0.9% of patients receiving lebrikizumab vs 2.7% receiving placebo.
In Kwatra’s view, ADtouch underscores localized disease does not necessarily mean mild disease when atopic dermatitis affects high-function sites. Location, pain, itch, functional impairment, and patient-reported burden should all inform how clinicians assess severity, define treatment success, and prioritize patients for advanced therapies.
Despite progress in the field, Kwatra noted not every patient achieves clear or almost clear skin within a given trial window. He pointed to precision dermatology, an effort his group at the University of Maryland is pursuing through a dedicated center, as a way to better match treatments to patients, given atopic dermatitis is a heterogeneous disease with patients driven by different symptoms, anatomic sites, comorbidities, and immune profiles.
Additional unmet needs include better predictors of treatment response, durable improvement alongside rapid onset, and greater attention to underrecognized dimensions of disease burden, including pain, sleep disturbance, mental burden, and functional impairment.
Editor's Note: This summary has been edited for grammar and clarity using artificial intelligence tools. Kwatra's disclosures included the following: AbbVie, Arcutis Biotherapeutics, ASLAN Pharmaceuticals, Celldex Therapeutics, Galderma, Genzada Pharmaceuticals, Incyte, Johnson & Johnson, Novartis, Pfizer, Regeneron Pharmaceuticals Inc., Sanofi – advisory board member/consultant; Galderma, Incyte, Pfizer, Sanofi – investigator.
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