Q&A: Insights on New Lebrikizumab Findings for Hand and Foot Atopic Dermatitis

The phase 3b ADtouch trial concluded lebrikizumab (Ebglyss) monotherapy attained its primary and secondary endpoints at the 16-week mark, according to late-breaking data presented at the European Academy of Dermatology and Venereology (EADV) Congress 2026.¹ The randomized, double-blind, placebo-controlled study (NCT06921759) enrolled 221 adult and adolescent subjects with moderate-to-severe hand and foot atopic dermatitis and an inadequate response to topical therapy, most with limited disease elsewhere on the body.²

“For people with hand and foot atopic dermatitis, a relatively small area of affected skin can have an outsized impact on daily life,” said Shawn G. Kwatra, MD, the Joseph W. Burnett endowed professor and chair in dermatology at the University of Maryland School of Medicine.

At Week 16, 53% of these individuals on lebrikizumab 250 mg every 2 weeks saw clear or almost clear hands and feet (HF-IGA 0/1 with a ≥2-point improvement) as opposed to 27% on placebo.¹ A ≥4-point improvement in hand and foot itch occurred in 57% versus 19% of patients, and a ≥4-point improvement in hand and foot pain occurred in 59% vs 19%, according to Eli Lilly and Company.² Among those dissatisfied with hand clearance at the point of baseline, 77% given lebrikizumab reported being satisfied or very satisfied vs 40% receiving placebo.²

Safety was consistent with the known profile of lebrikizumab, with no new safety signals.² Lilly has submitted the data to the US Food and Drug Administration for a potential label update covering localized atopic dermatitis with moderate-to-severe hand and foot involvement.²

In the following interview, Kwatra spoke with HCPLive at EADV 2026 in Vienna, Austria, about the clinical significance of ADtouch, its patient-reported outcomes, and the unmet needs remaining in hand and foot disease:

HCPLive: What is the overall significance of the ADtouch study for patients with atopic dermatitis?

Shawn G. Kwatra, MD: A significant subset of patients who have atopic dermatitis have very significant involvement of their hands and feet, and the broader significance is this study reinforces the idea that disease burden is not defined by body surface area alone. Atopic dermatitis can be highly consequential, especially on special sites such as the hands and the feet, even if the total amount of skin involved is relatively small.

So for patients, what matters is not just how much skin is affected, but whether disease is causing pain, itch, sleep disruption, difficulty working, difficulty walking, or interferes with normal daily activities like cooking. ADtouch is a study highlighting how treatment success should be multidimensional. We want to see skin clearance, but we also want to see itch and pain decrease significantly and fast. We want to see improved overall function and quality of life, and we want to close the loop. We don’t just want an investigator global assessment to get better. We want patients to actually feel satisfied with their level of disease control.

So, for patients with atopic dermatitis more broadly, I think this supports a more patient-centered definition of severity and treatment success. It looks beyond body surface area and incorporates symptom burden, location, function, and the patient’s own experience of the disease. ADtouch in particular is a phase 3 randomized, double-blind, placebo-controlled study designed specifically to evaluate lebrikizumab in adults and adolescents with moderate to severe atopic dermatitis involving the hands and the feet who had an inadequate response to topical therapy.

That’s what makes this study so important: hand and foot atopic dermatitis is a very high-impact phenotype. These patients may have a relatively limited overall body surface area, but again, functionality is very important: the itch, the pain, the difficulty walking, the quality of life impairment.

HCPLive: What are the key ADtouch findings you would highlight for clinicians?

Shawn G. Kwatra, MD: The key findings are that at Week 16, 53% of patients treated with lebrikizumab achieved clear or almost clear hands and feet, compared with 27% on placebo. We also saw clinically meaningful improvements in itch, 57% versus 19%, and improvements in pain, 59% versus 19%. Itch improvement was apparent as early as Week 2.

In terms of pain, I think this is, in my view, almost a paradigm-altering study from the pain perspective. Pain, especially with fissured areas on the hands and feet, is an important and underrecognized aspect of atopic dermatitis affecting the hands and feet. These are dramatic results I think patients would want to know about.

Another particularly interesting finding was patient satisfaction. Among patients who were dissatisfied with their hand clearance at baseline, 77% of those treated with lebrikizumab were satisfied or very satisfied with their hand clearance at Week 16. This adds an important patient perspective. To close the loop with treating a patient, you want to make sure they’re satisfied, which they are.

From a safety standpoint, the findings were consistent with the established safety profile of lebrikizumab, and there were no new safety signals identified. Adverse events were generally mild to moderate, and treatment discontinuations due to adverse events were uncommon.

To me, again, the broader significance here is this study reinforces the limitations of relying on body surface area alone to determine disease severity. Localized disease does not necessarily mean mild disease when atopic dermatitis affects high-function sites such as the hands and feet. Location, pain, itch, functional impairment, and patient-reported burden all need to be a part of how we assess severity and treatment success, and also how we prioritize patients for advanced therapies, to make sure they get their disease under control.

So the big takeaway is ADtouch is not just showing skin clearance. It’s showing improvements across clinician-assessed disease, symptoms, functionally important outcomes, and patient satisfaction in these difficult-to-treat areas of the hands and the feet. And it’s giving us a much more complete picture of treatment benefit in these patients.

HCPLive: Where do unmet needs remain for patients with hand and foot atopic dermatitis?

Shawn G. Kwatra, MD: I think we’ve made significant progress in atopic dermatitis, but one of the things we’re uncovering is not every patient will achieve the level of control they want at the same time point. In some of these high-level studies, not every patient may achieve clear or almost clear in that time window. What we need to better understand is what I call precision dermatology: what is a way to match the right treatment to the right patient?

Here at Maryland, we have created a center for precision dermatology where we’re attacking this question head on. We’re trying to map out atopic dermatitis as a heterogeneous disease, knowing different patients are driven by different symptoms, different anatomic sites, different comorbidities, and different immune profiles, which leads to different treatment priorities. So we still need better ways to predict who will respond best to which therapy.

Durability is also important. Patients want treatments that work quickly, but they also want sustained improvement. And finally, I think we still need to do a better job of appreciating underrecognized dimensions of disease burden: pain, sleep disturbance, mental burden, functional impairment, all of those things.

Editor’s Note: This transcript has been edited for grammar and clarity using artificial intelligence tools.

References

1. Silverberg K, Simpson E, Laquer V, et al. Lebrikizumab is effective in patients with atopic hand and foot dermatitis: 16-week results from the randomized, double-blind, placebo-controlled ADtouch trial. Presented at: European Academy of Dermatology and Venereology Congress 2026; September 30-October 3, 2026; Vienna, Austria.

2. Eli Lilly and Company. New phase 3b data show Lilly’s EBGLYSS (lebrikizumab-lbkz) delivered significant and rapid improvements in skin clearance, itch, pain, and patient satisfaction in people with moderate-to-severe hand and foot atopic dermatitis. Published September 30, 2026. Accessed October 14, 2026. https://investor.lilly.com/news-releases/news-release-details/new-phase-3b-data-show-lillys-ebglyss-lebrikizumab-lbkz.