Real-World Effectiveness of Lebrikizumab in Patients With Head-Neck Atopic Dermatitis

BACKGROUNDHead-neck atopic dermatitis (HND) represents a clinically challenging phenotype of atopic dermatitis (AD). Currently, real-world evidence on lebrikizumab specifically focusing on patients with head-neck involvement remains limited, as well as data on flare occurrence and management during treatment with this biologic drug. This real-life study aimed to evaluate the effectiveness of lebrikizumab in patients with HND, with particular attention to flare occurrence and management.

METHODSA multicenter retrospective observational study was conducted enrolling patients with AD involving the head-neck region treated with lebrikizumab and with at least one follow-up visit. The primary endpoint was the change in head-neck Eczema Area and Severity Index (EASI-HN) from baseline to Week (W) 16. Secondary outcomes included changes in total EASI, pruritus Numerical Rating Scale (P-NRS), Dermatology Life Quality Index (DLQI), EASI75/EASI90 response rates, and head-neck flare occurrence during follow-up.

RESULTSA total of 197 patients were included. Median baseline total EASI and EASI-HN were 20.0 (interquartile range [IQR] 8.0-25.0) and 3.0 (IQR 2.0-4.0), respectively. Among patients with paired W16 data (n = 118), median EASI-HN decreased from 2.8 to 1.0 (p < 0.001), while total EASI decreased from 20.0 to 3.0 (p < 0.001). Significant improvements were also observed in P-NRS and DLQI. Among patients with available W52 data (n = 53), EASI75 and EASI90 were achieved by 69.8% and 62.3%, respectively. Overall, 39/197 patients (19.8%) experienced at least one documented head-neck flare during follow-up, whereas 54/197 (27.4%) experienced at least one flare-related event, defined as a documented flare and/or rescue therapy use. Most patients experiencing flare-related events were managed with topical therapies, and no treatment discontinuations occurred.

CONCLUSIONSLebrikizumab demonstrated rapid and sustained effectiveness in patients with HND, with marked improvements in disease severity, pruritus, and quality of life. Head-neck flares were relatively uncommon and generally manageable with topical therapies.

Abstract from PubMed