by Peter Lio, MD, FAAD

After many years of stagnation, the landscape of atopic dermatitis (AD) treatment is finally getting exciting. It joined psoriasis in the biologic revolution with the advent of dupilumab in 2017, but that was only the beginning. There are now a number of agents in development, including several biologic agents. Lebrikizumab, an IL-13 inhibitor, is one such biologic that holds promise for AD and Dr. Guttman presented the data of the Phase 2b trial here for the first time. 

Lebrikizumab demonstrated clinical efficacy, with a dose-dependent and significant improvement in the primary endpoint across all doses, as well as showing significant improvement in POEM at week 16. Remarkably, pruritus improvements were seen as early as day 2, with sleep improvements (as one might expect) occurring just a few days later, continuing to improve through week 16. It was generally well tolerated, with a safety profile consistent with previous studies. 

My sense is that it appears roughly comparable in both safety and efficacy to dupilumab, with the very big caveat that one cannot compare such measures across studies directly. This is important because there are still many unmet needs in our moderate and severe patients, and this has been heightened with a pandemic making traditional immunosuppressants even more undesirable than ever before.

As this and other drugs come to market, we will hopefully be blessed with an embarrassment of riches, forcing competition for access and cost for the incumbents, and for new heights of safety and efficacy for drugs in development, all further empowering us to have more options for our patients. Some may be better suited for certain individuals as we continue to move towards the goal of precision and personalized medicine.