Treatment with tralokinumab, a fully human monoclonal antibody that binds to and neutralizes interleukin-13 (IL-13), was associated with improvements in disease symptoms in patients with moderate to severe atopic dermatitis (AD), in a recent phase 2b study published in the Journal of Allergy and Clinical Immunology.

The randomized, double-blind, placebo-controlled, dose-ranging study assigned 204 patients to receive placebo or 45 mg, 150 mg, or 300 mg of tralokinumab administered subcutaneously every second week for 12 weeks. The groups had similar demographics and disease characteristics. The patients were aged 15-75 years and had Eczema Area and Severity Index (EASI) scores of 12 or more and an Investigator Global Assessment (IGA) score of 3 or higher. The coprimary endpoints were change in EASI from baseline to week 12 and the percentage of patients with either 0 (clear) or 1 (almost clear) on the IGA scale.

The higher dosages of tralokinumab showed the greatest adjusted mean differences in EASI scores: reductions of 4.36 for the 150-mg group (P = .03) and 4.94 for the 300-mg group (P = .01), compared with placebo. The changes in the 300-mg group were apparent as early as 4 weeks into treatment and were maintained beyond the 12-week mark. The greatest differences, compared with placebo, in IGA were seen in the 300-mg group as well.

Furthermore, patients who had high levels of biomarkers associated with IL-13 showed greater improvements than those seen in the intention-to-treat population at large. By week 12, patient-reported pruritus was also improved, and there were improvements in Dermatology Quality of Life Index (which did not persist past 12 weeks).

Most treatment-emergent adverse events were considered only mild or moderate, and the few more serious events were deemed unrelated to the study drug. The most common adverse events were upper respiratory infections and headaches.

“Participants entering the study had not achieved an adequate response to stable topical glucocorticoids during the 2-week run-in period and, therefore, represent a population with moderate to severe AD and major unmet treatment needs,” the investigators wrote. “The clinically meaningful benefits observed by combining tralokinumab treatment with topical glucocorticoids suggests that tralokinumab could demonstrate improvements in participants whose symptoms cannot be effectively controlled by topical glucocorticoids alone.”

The study was funded by MedImmune, a member of the AstraZeneca Group. Five authors were or are employees of the company; the three remaining authors had disclosures related to numerous pharmaceutical companies, including two with disclosures that included MedImmune.

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SOURCE: Wollenberg A et al. J Allergy Clin Immunol. 2018 Jun 12. doi: 10.1016/j.jaci.2018.05.029.