ADmirable Trial: Lebrikizumab Shows Efficacy in AD Among Skin of Color Populations
KEY TAKEAWAYS
In the ADmirable trial, 78.4% of patients with skin of color achieved EASI 75 by week 24 on lebrikizumab.
Post-inflammatory hyperpigmentation improved in 64.4% of affected patients; nearly 1/4 acheived normal skin tone.
Lebrikizumab’s efficacy and safety in a historically underrepresented AD population as documented by the study.
Lebrikizumab significantly improved atopic dermatitis (AD) outcomes in patients with skin of color in the ADmirable phase 3b trial.
The ADmirable study, and open-label, 24-week trial evaluating lebrikizumab in patients with Fitzpatrick skin phototypes IV–VI and non-White racial backgrounds, included 90 adults and adolescents (≥12 years) with moderate-to-severe AD from 44 U.S. sites. At baseline, 77.8% of participants identified as Black or African American, and 21.1% identified as Hispanic or Latino at study baseline. Patients received lebrikizumab 250 mg every two weeks for 16 weeks, following a loading dose. Responders transitioned to every-4-week dosing through week 24. The primary endpoint was EASI 75 at 16 weeks.
According to the results, at 16 weeks, 69.2% of participants achieved EASI 75, increasing to 78.4% by week 24. Improvements in EASI 90 (47.3%), IGA 0/1 (54.1%), and pruritus and skin pain reduction were also sustained through 24 weeks. Dyspigmentation, assessed via PDCA-Derm™, improved in over 60% of patients with hyperpigmentation. Notably, 25% of those with hypopigmented lesions showed improvement, despite the persistent nature of pigment loss.
PO-SCORAD™ showed a mean percent reduction of over 50% from baseline, according to the data. Almost 70% of patients reported being mostly or completely satisfied with treatment outcomes. These findings align with prior subgroup analyses from pivotal trials. The safety profile was consistent with earlier studies, and no serious adverse events or discontinuations due to treatment were reported. Reported treatment-emergent adverse events were mostly mild or moderate (2.2% severe).
“This study helps support the efficacy and safety of lebrikizumab in patients with skin of color and Fitzpatrick skin phototypes 4-6, a population for which data has been historically limited," derematologist and coinvestigator Dr. Andrew Alexis told Practical Dermatology. "The inclusion of novel endpoints such as improvement in AD-related post inflammatory pigment changes helps to improve our understanding of this important sequela of AD that contributes to the burden of disease in patients with skin of color.”