Long-Term Management of Atopic Dermatitis: The Role of Tralokinumab

Atopic dermatitis (AD), also known as eczema, is a chronic inflammatory skin disease that affects millions of patients worldwide. Results from the ECZTEND trial (NCT03589339), an open-label extension study and the longest biologic and AD study of its kind, supported the continued efficacy and generally favorable safety and tolerability of tralokinumab administered for up to 6 years. This study data provides the longest data on any biologic for the treatment of atopic dermatitis, offering hope of lifelong management of AD using innovative treatments to transform the treatment of disease for patients with AD. The findings from the trial provide patients and their treating physicians greater understanding of the potential for long-duration clinical clearing and continued disease control with tralokinumab treatment. More than half of the patients studied continued to achieve clinical clear or almost clear status after years of continued treatment.

Why It Matters

Atopic dermatitis is more than just ‘skin deep’; it has significant emotional and physical impact on the lives of patients and their families. The symptoms of atopic dermatitis, which include severe itch (pruritus), skin discomfort and disturbed sleep, have a substantial impact on health-related quality of life and can create a heavy disease burden. Improved treatment options for patients suffering from atopic dermatitis are needed. Tralokinumab may offer sustained control of symptoms of atopic dermatitis for a prolonged period, unlike current conventional immunosuppressive therapies that lose efficacy over time.

Beyond the Surface

Patients with extensive psoriasis continued to experience sustained clinical improvements and clearance of disease for over 5 years following treatment with tralokinumab administered every 4 weeks. The majority of patients with chronic skin diseases require long-term therapy, however currently available treatments have limited duration of efficacy due to loss of efficacy or safety concerns. The need for long duration of therapy in chronic skin diseases makes tralokinumab, an IL-13 specific inhibitor, an attractive novel option for the treatment of type 2 inflammatory skin diseases. In comparison, currently available therapies for chronic inflammatory skin diseases are broad-spectrum immunosuppressants with significant safety concerns.

Could tralokinumab be a long lasting treatment? Interesting to see that at Week 248 (6 years!) 92.5% of patients on 300mg every 4 weeks had achieved EASI-75. But even more impressive was the IGA data, with 55.4% of patients achieving either “clear” or “almost clear” skin (IGA 0/1). Being left with stable flares of skin disease that require no further treatment is certainly something to be positive about.

The Science of Long-Term Success

This is a long-term safety and efficacy study in adult and pediatric patients 12 years and older with moderate-to-severe atopic dermatitis (also known as eczema) who participated in ECZTRA 1, 2 and/or 3 trials. The ECZTEND trial provides the opportunity for these patients to be followed for the “safety tail” duration of 248 weeks plus the median duration of active treatment of 44 weeks for up to 6 years.

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