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Analysis of phase 3 trial data show about two-thirds of patients with atopic dermatitis who responded to the IL-13 inhibitor also saw benefit for difficult-to-treat hand and face eczema.
A majority of patients with atopic dermatitis receiving lebrikizumab achieved improvement in facial and hand eczema in 16 weeks, according to an analysis of 3 pivotal clinical trials.
In late-breaking data presented at the Revolutionizing Atopic Dermatitis (RAD) 2023 Spring Conference in Washington, DC, the investigative interleukin-13 (IL-13) inhibitor provided significant improvements to rates of cleared or improved facial and hand dermatitis in patients from a trio of phase 3 trials versus placebo—regardless of combination topical corticosteroid (TCS) use.
Led by Jenny E. Murase, MD, of the department of dermatology at the University of California San Francisco, the team of US-based investigators sought to report the efficacy of lebrikizumab in treating hand and facial dermatitis across the Eli Lilly-funded ADvocate 1 and 2 and ADhere trials.
As Murase explained in a recent interview with HCPLive, patients with chronic hand and facial eczema are particularly impacted in their quality of life while struggling to adequately treat the condition.
“Patients feel like they can't leave the house because their face is covered in dermatitis that can be cracking, oozing,” Murase explained. “They can't use their hands to just function because there's fissures and pain associated with the disease. So it just makes it that much more impactful to have those 2 areas of the body in particular involved.”
Little has been investigated into the efficacy of lebrikizumab in difficult-to-treat regions of atopic dermatitis—despite robust evidence of overall benefit for moderate to severe disease in adolescent and adult patients from the ADvocate trial program and the ADhere trial.
ADvocate 1 and 2 assessed monotherapy 250 mg lebrikizumab every 2 weeks versus placebo for 16 weeks, while ADhere assessed low-to-mid potency TCS plus lebrikizumab every 2 weeks versus a control of TCS plus placebo for 16 weeks.
In this analysis, Murase and colleagues observed patients with any identified facial or hand dermatitis who reported improved or cleared atopic dermatitis with lebrikizumab from baseline at week 16 from any of the 3 trials.
Facial dermatitis was identified in 202 (71.4%) patients receiving lebrikizumab and 114 (80.9%) patients receiving placebo. Investigators reported that 125 (61.9%) patients receiving treatment reported improved or cleared facial dermatitis versus just 36 (31.6%) patients receiving placebo at week 16 (P <.001).
Hand dermatitis was additionally identified in 204 (72.1%) patients receiving lebrikizumab and 103 (73.0%) patients receiving placebo. Approximately two-thirds (n = 137 [67.2%]) of lebrikizumab-treated patients reported improved or cleared skin versus 30 (29.1%) patients on placebo at week 16 (P <.001).
Facial dermatitis was identified in 207 (73.7%) patients receiving lebrikizumab and 115 (78.8%) patients receiving placebo. The team reported 119 (57.5%) patients on treatment achieved improved or cleared skin at 16 weeks, versus just 25 (21.7%) of patients on placebo (P <.001).
Another 206 (73.3%) patients on lebrikizumab were observed to have hand dermatitis at baseline; 106 (72.6%) patients on placebo also had hand dermatitis. Again, approximately two-thirds (n = 127 [61.7%]) of patients receiving lebrikizumab reported cleared or improved hand dermatitis at 16 weeks, versus 20 (18.9%) patients on placebo (P <.001).
At baseline, 105 (72.4%) patients receiving TCS plus lebrikizumab and 39 (59.1%) of patients on TCS plus placebo were identified with facial dermatitis. The combination therapy resulted in 72 (68.6%) patients reaching improved or cleared skin at 16 weeks versus 18 (46.2%) patients on TCS plus placebo (P = .02).
Finally, 103 (71.0%) patients receiving TCS plus lebrikizumab had hand dermatitis at baseline versus 44 (66.7%) patients receiving TCS plus placebo. Hand dermatitis was cleared or improved in 75 (72.8%) of treated patients versus just 19 (43.2%) of control arm patients at 16 weeks (P = .001).
Murase told HCPLive the findings buck against a misconception that such IL-13-targeting agents do not benefit outcomes like facial dermatitis.
“I certainly hope that clinicians moving forward realize this, and that if a patient has involvement of the face that they still consider these agents because they can be helpful in the majority of patients that are experiencing issues on their face and hands,” Murase said.
Indeed, she and colleagues concluded in their pooled analysis that lebrikizumab is effective in both improving and clearing hand and face dermatitis in a majority of treated patients at 16 weeks.