Lebrikizumab improves atopic dermatitis symptoms in patients previously on dupilumab

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A new Phase-3b study has found that lebrikizumab (EBGLYSS; Lilly), a monoclonal antibody targeting interleukin-13, improves itch, sleep interference, and skin pain in patients with moderate-to-severe atopic dermatitis (AD) who were previously treated with dupilumab (Dupixent; Sanofi and Regeneron). The findings were presented at the 2025 American Academy of Dermatology (AAD) meeting.

The study, ADapt (NCT05369403), was an open-label, 24-week trial that evaluated the efficacy of lebrikizumab in adults and adolescents who discontinued dupilumab due to inadequate response, intolerance, or other reasons.

Participants received lebrikizumab 250 mg every two weeks (LEBQ2W) until week 16. Those achieving Investigator’s Global Assessment (IGA) 0/1 with a ≥2-point improvement or Eczema Area and Severity Index (EASI-75) response transitioned to a four-week dosing schedule (LEBQ4W) until week 24. Other patients continued with LEBQ2W.

At weeks 16 and 24, patients experienced notable symptom improvements. "The proportions of patients achieving Pruritus Numeric Rating Scale (PNRS) ≥3-point improvement were 72.9% and 77.5% observed, respectively," according to the study authors. The proportion of patients reaching ≥4-point PNRS improvement also increased over time, with 53.2% at week 16 and 61.5% at week 24.

Sleep interference, a key concern for AD patients, also improved. The study reported that "Sleep-Loss Scale ≥2-point improvement was achieved by 41.7% and 42.1% of patients at weeks 16 and 24, respectively." Additionally, skin pain, as assessed by the Skin Pain Numeric Rating Scale (NRS), showed significant improvement, with 58.8% of patients achieving at least a 4-point reduction at week 16 and 75.0% at week 24.

Among those who discontinued dupilumab due to inadequate response, 65.2% achieved a ≥3-point PNRS improvement, while 50.0% reached a ≥4-point improvement at week 16.

The study concludes that "lebrikizumab resulted in clinically meaningful improvements in the symptoms of itch, itch interference on sleep, and skin pain in patients previously exposed to dupilumab."

These findings suggest lebrikizumab may offer relief for AD patients who have not achieved adequate symptom control with dupilumab, providing another treatment option for those with persistent symptoms.

Reference:

Yosipovitch G, Ackerman L, Bagel J, et al. Lebrikizumab improves itch, itch interference on sleep and skin pain in patients with moderate-to-severe atopic dermatitis previously treated with dupilumab. Poster. Presented at: The 2025 American Academy of Dermatology Annual Meeting. Orlando, Florida.