P109 Lebrikizumab for the treatment of moderate-to-severe atopic eczema: real-world experience from a tertiary centre

Abstract Lebrikizumab, a human monoclonal antibody that targets interleukin-13, is approved for treating atopic dermatitis. However, there is a lack of real-world data to evaluate its efficacy and safety. This retrospective study analysed the Eczema Area and Severity Index (EASI) and Dermatology Life Quality Index (DLQI) scores at baseline and after 16–20 weeks among 36 consecutive patients who received lebrikizumab per label in a UK tertiary centre. Adverse events, including instances of conjunctivitis, were recorded. By week 16–20, EASI scores were recorded for 17 patients; 15 patients had not reached the timepoint and four had discontinued treatment. The average treatment duration was 4.2 months (n = 36). At the 16–20-week assessment, 76% (13 of 17) had achieved EASI 50 (≥ 50% improvement from baseline), 53% (9 of 17) had reached EASI 75, and 24% (4 of 17) had attained EASI 90. The DLQI demonstrated a mean change of −12.2 points (range +3 to −30) at the 16–20-week timepoint. Adverse events were reported in 31% (11 patients). Nine individuals experienced ocular adverse events, including conjunctivitis (5 of 36), dry eyes (2 of 36), itchy eyes (1 of 36) and corneal infiltrates (1 of 36). Six patients (17%) discontinued lebrikizumab, due to injection-site reactions (two of six), primary failure (one of six), conjunctivitis (one of six), corneal infiltrates (one of six) and drug sensitivity reactions (one of six). No serious adverse events were noted. Sixteen patients had previously been treated with dupilumab and switched to lebrikizumab, due to primary failure (n = 3), secondary failure (n = 7), conjunctivitis (n = 5) and/or facial erythema (n = 3). Similarly, seven patients had switched from tralokinumab, due to primary failure (n = 5), secondary failure (n = 2) and/or ocular symptoms (n = 3). Ten patients experienced ocular symptoms while on dupilumab (n = 8) or tralokinumab (n = 3). Of these, eight experienced no recurrence of symptoms following transition to lebrikizumab. One patient developed conjunctivitis, and another experienced corneal infiltrates, leading to discontinuation of treatment. EASI response data were available for 10 of the 23 patients who had previously received a biologic or Janus kinase inhibitor, demonstrating EASI 50, EASI 75 and EASI 90 rates of 70%, 40% and 10%, respectively, at 16–20 weeks (n = 10). In this real-world cohort, lebrikizumab demonstrated comparable efficacy in treating atopic dermatitis to that observed in clinical trials (Silverberg JI, Guttman-Yassky E, Thaçi D et al. Two phase 3 trials of lebrikizumab for moderate-to-severe atopic dermatitis. N Engl J Med 2023; 388: 1080–91). Moreover, lebrikizumab serves as a viable alternative for patients who experienced ocular complications with previous biologic therapies. Further long-term follow-up is essential in larger cohorts to fully assess the future role of lebrikizumab.