Novel Efficacy Index Compares Long-Term Therapy Outcomes in Atopic Dermatitis Treatments

In a new approach to assess long-term treatment outcomes for atopic dermatitis (AD), researchers have introduced a novel efficacy index that accounts for both on-drug and off-drug responses at Week 52. According to a poster presentation at the Revolutionizing Atopic Dermatitis (RAD) June 2024 meeting, the study compared maintenance outcomes of lebrikizumab, tralokinumab, and dupilumab, 3 prominent therapies for AD.

Atopic dermatitis, a chronic inflammatory condition, often requires continuous therapy, though interruptions may occur in real-life scenarios. The objective was to develop an efficacy index that evaluates responses based on Investigator’s Global Assessment (IGA) scores of 0 or 1 and Eczema Area and Severity Index (EASI) reductions of 75%, reflecting treatment efficacy under different adherence conditions.

The analysis included patients who responded positively to treatment at 16 weeks and were subsequently randomized to either continue therapy or withdraw treatment up to Week 52. Lebrikizumab was administered at 250 mg every 4 weeks (ADvocate1; ADvocate2), tralokinumab at 300 mg every 2 weeks (ECZTRA1; ECZTRA 2), and dupilumab at 300 mg weekly or every 2 weeks (SOLO-CONTINUE).

Results of the efficacy index, incorporating non-responder imputation, revealed the following response rates (95% CI) at Week 52:

• IGA 0,1 response: Lebrikizumab 53% (45%-61%), Tralokinumab 45% (37%-53%), Dupilumab 34% (28%-40%).
• EASI 75 response: Lebrikizumab 63% (55%-71%), Tralokinumab 42% (35%-49%), Dupilumab 51% (45%-57%).

Statistical comparisons indicated that lebrikizumab showed superior efficacy compared to dupilumab in achieving both IGA 0,1 and EASI 75 responses. Additionally, lebrikizumab outperformed tralokinumab in achieving EASI 75 responses.

“This novel efficacy index, which accounts for the importance of continuing or stopping therapy after Week 16, may be a useful tool to indirectly compare long-term treatment outcomes,” concluded the study authors. “Lebrikizumab’s higher efficacy index may translate to improved long-term management of AD.”

Reference:

Silverberg J, Irvine A, Foley P, Del Rosso J, et al. A novel efficacy index for long-term therapy outcomes expressed by maintenance of EASI 75 and IGA 0,1 response in atopic dermatitis. Poster presented at: Revolutionizing Atopic Dermatitis; June 8-10, 2024; Chicago, IL