Atopic dermatitis disease control with nemolizumab

Atopic dermatitis (AD) management should be guided by disease activity. Continuous follow-up after initiating treatment is necessary to determine whether adequate disease control has been achieved. Recommended AD disease control targets include clinically meaningful changes in skin lesions, itch and quality of life (QoL), utilizing clinician- and patient-reported measures. This analysis assessed disease control as a composite of skin lesions, itch and QoL, in patients with AD treated with nemolizumab up to 2 years in the ARCADIA long-term extension (LTE; NCT03989206). This ARCADIA LTE post hoc analysis included adult patients who were either nemolizumab previously experienced (NPE) or nemolizumab naive (NN). Disease control was assessed (observed cases) at weeks 20, 56 and 104 and defined as achieving a composite of ≥ 75% reduction from lead-in baseline in Eczema Area and Severity Index (EASI 75), and a ≥ 4-point improvement from lead-in baseline in both itch visual analogue scale (VAS) and Dermatology Life Quality Index (DLQI). This study was funded by Galderma. As previously reported as individual endpoints, at week 104 (vs. lead-in baseline; observed cases), in NPE and NN patients, respectively, 88.2% and 85.4% achieved EASI 75, 87.2% and 82.0% achieved ≥ 4-point improvement in itch VAS, and 92.2% and 91.0% achieved ≥ 4-point improvement in DLQI. The proportion of NPE patients achieving the composite endpoint of disease control continued to increase over 2 years, being 44.5% (367 of 824) at week 20, 56.4% (384 of 681) at week 56 and 67.9% (340 of 501) at week 104. The proportion of NN patients achieving disease control showed a similar trend, being 40.6% (234 of 576) at week 20, 54.4% (253 of 465) at week 56 and 59.7% (187 of 313) at week 104. Long-term treatment with nemolizumab was associated with high levels of AD disease control, with continuous improvements up to 2 years. In both the NPE and NN arms, > 40% of patients achieved disease control by week 20, rising to approximately 60% by week 104.

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