Real-world Treatment Persistence of Lebrikizumab by Atopic Comorbidity Among Patients with Moderate-to-severe Atopic Dermatitis in the US

Introduction: Lebrikizumab, a monoclonal antibody selectively targeting interleukin-13, is an approved therapy for atopic dermatitis (AD). This study evaluated the relationship between real-world treatment persistence and atopic comorbidity status among lebrikizumab initiators. Methods: This retrospective study analyzed secondary claims data from the IQVIA PharMetrics dataset. Eligible participants were aged ≥12 years, had an AD diagnosis in the pre-index period (12 months prior to index fill), initiated lebrikizumab (≥1 fill) between October 1, 2024–July 31, 2025, had ≥12 months of continuous pre-index enrollment without lebrikizumab dispensing, and a ≥6-month follow-up. Baseline characteristics identified included demographics, prior advanced systemic therapy experience, and comorbidities in the pre-index period. Persistence was defined as the absence of switching to an alternative therapy within six months of lebrikizumab initiation rather than discontinuation (a treatment gap). Longer gaps between fills may reflect real-world dosing rather than a lapse in therapy. Persistence rates (proportion of participants who switched at six months post-index vs. those who did not) were reported across comorbidity burden categories (no comorbidity, ≥1, ≥2), specifically for asthma and allergic rhinitis, as well as bio-experience (evidence of ≥1 pharmacy or medical-benefit claim for a biologic or a JAK inhibitor during the 12-month pre-index period). Data were analyzed descriptively. Results: Among 355 lebrikizumab initiators, 38.6% were 18-44 years, 56.9% female, and 68.7% advanced systemic therapy experienced. Overall, 63.9% (227/355) had no comorbidities, 36.1% (128/355) had ≥1 comorbidity (asthma: 21.7% (77/355); allergic rhinitis: 20.3% (72/355)), and 14.1% (50/355) had ≥2 comorbidities. At six months, overall persistence (83.1%) was consistent across groups: AD, no comorbidities: 84.1%; ≥1 comorbidity: 81.3%; ≥2 comorbidities: 82.0%. Persistence was also numerically similar among participants with or without comorbidities of interest (asthma: 84.4% versus no asthma: 82.7%; allergic rhinitis: 81.9% versus no allergic rhinitis: 83.4%) and among patients who were bio-experienced (81.6%) versus bio-naïve (86.5%). Conclusions: In this real-world study, lebrikizumab initiated in patients with or without comorbidities demonstrated six-month persistence that was consistent regardless of atopic comorbidity burden or prior biologic use.