RAD 2026: Tralokinumab Improves Hand AD Outcomes, Outperforms Dupilumab in MAIC

Phase 3b ADHAND trial data show tralokinumab (Adbry) significantly improved hand eczema severity, work productivity, and daily activity in adults with atopic dermatitis (AD) and moderate-to-severe hand involvement, with a matching-adjusted indirect comparison (MAIC) favoring tralokinumab over dupilumab (Dupixent) on deep response and activity impairment.1,2

According to LEO Pharma, the 32-week ADHAND trial (NCT05958407) marks the first phase 3b study designed specifically for patients with AD and moderate-to-severe hand eczema, a population with limited evidence from dedicated randomized trials.

ADHAND trial design and primary efficacy at 32 weeks

ADHAND was a phase 3b, international, multicenter, randomized, 32-week, double-blind, placebo-controlled, parallel-group, adaptive trial followed by a 16-week open-label treatment period. The trial enrolled adults with moderate-to-severe atopic hand eczema, a Hand Eczema Symptom Diary (HESD) itch score of at least 4, and an inadequate response to topical prescription medications within the prior year were enrolled. No background topical therapy was permitted on the hands during the double-blind period.

A total of 235 participants were randomized 2:1 to tralokinumab 300 mg every 2 weeks (n=156) or placebo (n=79). The trial’s primary endpoint was met, with 40.0% of patients receiving tralokinumab achieving IGA-AHE 0/1 at Week 16 versus 10.6% with placebo (treatment difference 29.7%; 95% CI, 19.0-40.4; P <.001). Investigators pointed out response rates continued to climb through week 32, with 57.9% (77/133) of patients who continued tralokinumab achieving IGA-AHE 0/1 at that timepoint (observed cases).1

On the Hand Eczema Severity Index (HECSI), 41.7% achieved HECSI-90 with tralokinumab versus 10.9% with placebo at Week 16 (treatment difference 30.8%; 95% CI, 20.0-41.5; P <.001). All key secondary HECSI thresholds (HECSI-50, HECSI-75) were also significantly greater for tralokinumab at Week 16, with further improvements through Week 32.1

Work Productivity, Daily Activity, Safety, & the MAIC vs Dupilumab

Among the 111 tralokinumab-treated participants who were currently employed, Work Productivity Impairment reductions were observed as early as week 2, the earliest measured timepoint. Activity Impairment, assessed among all participants regardless of employment status, showed significant improvement with tralokinumab versus placebo over the 16-week double-blind period. DLQI scores improved by a mean of 60.9% from baseline with tralokinumab versus 21.0% with placebo at week 16 (P <.001).1

Safety during the double-blind period was consistent with tralokinumab's established profile. Adverse events occurred in 60.3% of tralokinumab-treated patients and 60.8% of placebo patients. Serious adverse events were infrequent (1.9% vs 1.3%), and the incidence of severe adverse events was lower with tralokinumab (1.3%) than placebo (3.8%).1

In a separate anchored MAIC comparing tralokinumab with dupilumab, individual patient data from ADHAND were weighted to match age, sex, race, and baseline HECSI from the LIBERTY-AD-HAFT trial (NCT04417894). Tralokinumab significantly outperformed dupilumab on HECSI-90 at Week 16 (27.0% vs 9.5%; risk difference 17.5%; 95% CI, 0.8-34.2; P = .040) and on reduction in Percent Routine Activity Impairment (risk difference 16.0%; 95% CI, 4.8-27.1; P = .005). Other endpoints, including IGA 0/1, HECSI-75, HECSI percent reduction, and itch and pain measures, were numerically in favor of tralokinumab.2

A separate narrative review presented at Revolutionizing Atopic Dermatitis (RAD) 2026 Conference encompassing 16 clinical and real-world studies confirmed tralokinumab produced early, deep, and sustained improvements in high-burden area involvement, including head/neck and hands, across adult and adolescent patients regardless of skin color or prior systemic therapy history.3

References

1. Ehst B, Warren RB, Hong HCC, et al. Tralokinumab treatment in patients with atopic dermatitis and moderate-to-severe hand involvement: results from the 32-week phase 3b ADHAND trial. Presented at: Georg Rajka International Symposium on Atopic Dermatitis 2026; June 2026.

2. Armstrong A, Kircik L, Metelitsa A, et al. Tralokinumab versus dupilumab for the treatment of moderate to severe atopic dermatitis with hand involvement: a matching-adjusted indirect comparison. Presented at: Georg Rajka International Symposium on Atopic Dermatitis 2026; June 2026.

3. Chovatiya R, Bunick CG, Golant AK, et al. Tralokinumab in patients with moderate-to-severe atopic dermatitis with high-burden area involvement. Presented at: Georg Rajka International Symposium on Atopic Dermatitis 2026; June 2026.