Dr. Raj Chovatiya: Lebrikizumab Long-Term Data Makes 'Night and Day' Difference

New long-term results presented at the 2025 American Academy of Dermatology (AAD) Annual Meeting in Orlando, Florida, showed complete skin clearance (EASI-100 or IGA 0) at 3 years in patients with moderate-to-severe atopic dermatitis taking lebrikizumab (EBGLYSS™, Eli Lilly and Company) in the ADjoin long-term trial. Practical Dermatology Editorial Board member and study author Raj Chovatiya, MD, PhD, MSCI, spoke about the impact of the results.

WHAT'S THE MOST IMPORTANT TAKEAWAY FROM THIS NEWS?

In this poster that we presented at AAD this year, what we were taking a look at was some of the long-term, 3-year maintenance of efficacy data with lebrikizumab that was seen in the long-term extensions. The big message to take home is that, for those responders who were doing pretty well at 16 weeks of therapy, they largely were able to not only maintain that efficacy but—in terms of the people who stayed on therapy—potentially even raise that to levels that were measurable at some of our more common endpoints and also some of our more stringent endpoints where we're really looking at people getting nearly clear or completely clear and having really good control of their itch as well. It really suggests that people who seemingly do well after the first few months of therapy have the chance to keep doing really well and maybe do exceptionally well overall.

WHAT DO YOU THINK ABOUT THE SUGGESTION THAT TARGETING IL-13 COULD EVENTUALLY BE THE KEY TO A CURE, OR AT LEAST LONG-TERM REMISSION?

It is very sexy to talk about cures in the world of atopic dermatitis and dermatologic disease in general. One thing that appears to be clear with multiple targeting therapies for IL-13, including most recently lebrikizumab, is there seems to be a lot of data pointing us toward this idea of people being able to truly space out their doses. In the case of lebrikizumab trials and some older anti-IL-23 trials, even people who are withdrawn off therapy seemingly maintain some of these responses for a longer period of time than some might expect. I don't know if I would call that a cure, but it does highlight how IL-13 really is an important cytokine, both peripherally and maybe even more centrally as well for patients with atopic dermatitis.

HOW USEFUL ARE LONG-TERM EXTENSION STUDIES LIKE THIS IN TERMS OF MAKING PATIENTS FEEL COMFORTABLE AND ACCEPT THESE TREATMENTS?

It's really night and day in terms of what this gives not only healthcare providers but patients because people feel a certain degree of comfort knowing that it's a therapy that they may have to use chronically. But when you look at an FDA prescribing information package insert, you're typically focusing on data up to a few months. We know atopic dermatitis is not a disease of 3 to 4 months, so in my discussions with patients, it's really helpful to give them an example of what their situation could look like in the long run—not only from an efficacy standpoint but also safety, which is usually the main reason why people may be uncertain about use of a therapy in the long run.

LOOKING TO THE FUTURE AS YOU CONTINUE TO STUDY THIS DRUG, WHAT DO YOU EXPECT OR HOPE TO SEE OVER THE NEXT COUPLE OF YEARS?

Additional extension time will be fantastic to see about how people are doing beyond just that 3-year period. Additionally, we're seeing some great readouts, even at this meeting, of other lebrikizumab studies. ADmirable was another study that had a poster readout that was specifically looking at individuals with skin of color and non-white racial groups, and they largely displayed efficacy that was on par with what we'd expect. ADapt also had some data that was demonstrated here for individuals who previously were on medication like dupilumab and then were placed on lebrikizumab and showed that they also had improvement in the symptoms associated with their disease. It is really building a picture of lebrikizumab being a very clear option for our patients in the short run and the long run, and something that we can think about as really a first-line therapy.