Analysis: Lebrikizumab Viable Dupilumab Alternative for Moderate-to-Severe AD

10/25/2024

Lebrikizumab is a viable alternative for patients with moderate-to-severe atopic dermatitis (AD) who discontinue dupilumab due to inadequate response, inability to tolerate the drug, or other reasons, according to a new study presented at the Fall Clinical Dermatology Conference.

The study included 86 patients who had been off dupilumab for at least 4 weeks.

“The question was: If you had been on prior dupilumab and stopped it for one of these reasons, how would you do with lebrikizumab?” Dr. Linda Stein Gold, a dermatologist and one of the study investigators, told Practical Dermatology. “One targets IL-4 and IL-13, and one targets IL-13. They are different mechanisms of action, but similar in the family.”

The study authors found that the majority of patients achieved Eczema Area and Severity Index (EASI) 75—including those who had discontinued dupilumab due to inadequate response. Additionally, the 10 patients who had stopped dupilumab due to either facial erythema, vision side effects, or arthralgias did not develop any side effects with lebrikizumab.

“The bottom line is that these are drugs that work, really by different mechanisms of action, and if a patient has a problem with one drug, there is no reason not to try another drug,” Dr. Stein Gold said. “It is really important because we need to understand that we have a number of choices in the moderate-to-severe atopic dermatitis space, and that even if somebody tries one biologic that maybe does not work well for a variety of reasons, that does not preclude them from using another biologic and potentially having success.”

Dr. Stein Gold said she had been optimistic entering the study but was pleasantly surprised by both the tolerance and efficacy of lebrikizumab in this patient population.

“Patients just want to know if they can get better and what the side effects could be,” Dr. Stein Gold added.

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