Article Impact Level: HIGH Data Quality: STRONG Summary of Journal of the American Academy of Dermatology, 92(5), 1024–1031. https://doi.org/10.1016/j.jaad.2024.12.026 Dr. Emma Guttman-Yassky et al.
Points
- Patients with moderate-to-severe atopic dermatitis who did not respond to lebrikizumab by week 16 showed substantial improvement with extended treatment through week 52.
- By week 52, 75.5 percent of initial nonresponders achieved EASI 75, 44.2 percent reached EASI 90, and 36.1 percent attained clear or almost clear skin based on IGA criteria.
- A significant portion of patients, 66.4 percent, also reported at least a four-point reduction in itch severity, reflecting meaningful symptom relief.
- These findings highlight the potential for continued lebrikizumab therapy to yield delayed but clinically essential benefits in patients initially classified as nonresponders.
- The study supports using longer-term, personalized treatment strategies for managing atopic dermatitis with biologic therapies like lebrikizumab.
Summary
This study evaluates the efficacy of lebrikizumab in patients with moderate-to-severe atopic dermatitis who did not achieve protocol-defined response criteria at week 16 of treatment. Patients who failed to meet the response criteria—≥75% improvement in the Eczema Area and Severity Index (EASI 75) or Investigator Global Assessment (IGA) 0/1 with ≥2-point improvement—were allowed to continue with open-label lebrikizumab therapy for an additional 36 weeks. This analysis focused on the outcomes of patients treated every two weeks during the induction period, with concomitant topical therapies allowed.
At week 16, 38.1% of patients had not met the predefined response criteria, but 58.1% had achieved at least a 50% improvement in EASI. By week 52, 75.5% of these patients reached EASI 75, 44.2% achieved a 90% improvement (EASI 90), and 36.1% met IGA 0/1 with ≥2-point improvement. Additionally, 66.4% of patients reported a ≥4-point improvement on the Pruritus Numeric Rating Scale, indicating substantial relief from itching.
These results suggest that patients with moderate-to-severe atopic dermatitis who initially did not respond to lebrikizumab can benefit from extended treatment, demonstrating clinically meaningful improvements in skin lesions and itching. The findings support a more personalized approach to managing atopic dermatitis, as patients who may not respond initially can achieve significant long-term benefits with continued therapy.
Link to the article: https://www.jaad.org/article/S0190-9622(24)03414-5/abstract
References Guttman-Yassky, E., Rosmarin, D., De Bruin-Weller, M., Weidinger, S., Bieber, T., Hong, H. C., Elmaraghy, H., Atwater, A. R., Pierce, E., Xu, C., Agell, H., Garcia Gil, E., & Simpson, E. (2025). The efficacy of longer-term lebrikizumab treatment in patients with moderate-to-severe atopic dermatitis who did not meet protocol-defined response criteria at week 16 in 2 randomized controlled clinical trials. Journal of the American Academy of Dermatology, 92(5), 1024–1031. https://doi.org/10.1016/j.jaad.2024.12.026
