P106 Real-world experience of the efficacy and safety of tralokinumab use in atopic dermatitis: a multicentre audit

Abstract Systemic treatment of atopic dermatitis has advanced significantly in recent years. Tralokinumab, a fully human monoclonal antibody targeting interleukin-13, was approved in 2022 in the UK for the treatment of moderate-to-severe atopic dermatitis not responsive to conventional management. There is limited published local evidence of its efficacy and safety outside of clinical trials. We sought to review the practices surrounding use of tralokinumab for atopic dermatitis, and its efficacy and safety in two regional dermatology departments. Patient data were retrospectively reviewed for those for whom tralokinumab had been prescribed. Baseline demographics, duration of treatment with tralokinumab, previous treatments, clinical scoring and documentation of adverse effects were collected. These reviews were registered and approved locally with audit committees. In total, 39 patients were treated with tralokinumab from October 2022 to April 2024 in our centres. Data were missing for 10 patients, and these were excluded from analysis. The median treatment duration was 8 months (range 2–84). Median baseline Eczema Area and Severity Index (EASI) and Dermatology Life Quality Index (DLQI) scores were 18 and 20, respectively. At 16 weeks, these improved to 2.2 and 7, respectively. At 16 weeks, 73%, 67% and 33% of patients had achieved ≥ 50, ≥ 75 and ≥ 90% improvement in EASI (EASI 50, EASI 75 and EASI 90), respectively. The 26-week data were available for 10 patients: EASI 75 was achieved in 70%, and EASI 90 in 30%. Almost all patients were treated with standard 2-weekly dosing. One patient was on 4-weekly dosing and maintained an EASI of 1 and DLQI of 4 at 84 months. Six patients stopped treatment; reasons included severe keratoconjunctivitis (one patient) and suboptimal disease control (four patients). One patient was lost to follow-up before the 16-week review. Eight patients (27%) had ocular surface problems during treatment, three of which were newly reported (10% of patients) and five of which were pre-existent prior to tralokinumab. One patient discontinued treatment after 7 months due to persistence of severe pre-existing keratoconjunctivitis. One patient (3%) experienced flares of facial dermatitis on treatment, but continued at standard dosing. One patient died, unrelated to their atopic dermatitis or tralokinumab. Our real-world experience of tralokinumab supports existing evidence of its clinical efficacy and safety in treating atopic dermatitis. Ocular surface dryness and irritation was the most common reported adverse effect, although it was emergent in only 10% of patients. Minor infections or viral illnesses were likely under-reported at follow-up, although there were no serious infections. Longer-term follow-up will provide further evidence of efficacy and safety outside of trial settings.