Efficacy and Safety of Tralokinumab in US Adults with Moderate-to-Severe Atopic Dermatitis: A Post-hoc Analysis of ECZTRA3
Main Article Content
Keywords
Tralokinumab, Atopic dermatitis, Human monoclonal antibody, Interleukin, Efficacy, Safety profile
Abstract
Background: Tralokinumab, a monoclonal antibody that specifically neutralizes interleukin (IL)-13, is approved for the treatment of adults with moderate-to-severe atopic dermatitis (AD). Tralokinumab was studied in ECZTRA3 (NCT03363854), a randomized, double-blind, multi-national, placebo-controlled Phase 3 trial of tralokinumab in adults with moderate-to-severe AD.
Objective: We conducted a post-hoc analysis in the United States (US) subset of ECZTRA3 patients to inform healthcare practitioners and payers on the efficacy and safety of tralokinumab in the US setting.
Methods: Patients were treated with either 300 mg tralokinumab (n=63) or placebo (n=25) every 2 weeks (Q2W) in combination with TCS as needed for an initial 16 weeks. Thereafter, tralokinumab-treated patients continued with either Q2W dosing or Q4W+TCS for 16 additional weeks. Primary, secondary, and safety endpoints of the ECZTRA3 US subset were evaluated at 16 and 32 weeks following main statistical analyses (previously published).
Results: At Week 16, 37.1% tralokinumab+TCS vs 12.0% placebo+TCS reached Investigator’s Global Assessment (IGA) 0/1 (nominal P=0.039); 56.5% of tralokinumab+TCS vs 24.0% placebo+TCS (nominal P=0.012) achieved the Eczema Area and Severity Index (EASI)-75. Secondary, patient-reported outcomes including itch score and health-related quality of life (HRQoL) were also improved at Week 16 versus baseline, more so for tralokinumab+TCS group. Tralokinumab was well tolerated, with an overall safety profile comparable to placebo.
Conclusions: Consistent with the full ECZTRA3 population, US patients with moderate-to-severe AD treated with tralokinumab+TCS as needed achieved greater symptom relief, reductions in disease severity and improvement of HRQoL than placebo+TCS, with comparable safety.
References
2. Beasley R, of Asthma TIS. Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. The Lancet. 1998;351(9111):1225-1232.
3. Lee BW, Detzel PR. Treatment of Childhood Atopic Dermatitis and Economic Burden of Illness in Asia Pacific Countries. Annals of Nutrition and Metabolism. 2015;66(suppl 1)(Suppl. 1):18-24. doi:10.1159/000370221
4. Garrett JPD, Hoffstad O, Apter AJ, Margolis DJ. Racial comparison of filaggrin null mutations in asthmatic patients with atopic dermatitis in a US population. Journal of Allergy and Clinical Immunology. 2013/11/01/ 2013;132(5):1232-1234. doi:https://doi.org/10.1016/j.jaci.2013.07.005
5. Palmer CNA, Irvine AD, Terron-Kwiatkowski A, et al. Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis. Nature Genetics. 2006/04/01 2006;38(4):441-446. doi:10.1038/ng1767
6. Bieber T. Interleukin-13: Targeting an underestimated cytokine in atopic dermatitis. Allergy. Jan 2020;75(1):54-62. doi:10.1111/all.13954
7. Sidbury R, Tom WL, Bergman JN, et al. Guidelines of care for the management of atopic dermatitis: Section 4. Prevention of disease flares and use of adjunctive therapies and approaches. J Am Acad Dermatol. Dec 2014;71(6):1218-33. doi:10.1016/j.jaad.2014.08.038
8. Wollenberg A, Barbarot S, Bieber T, et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II. J Eur Acad Dermatol Venereol. Jun 2018;32(6):850-878. doi:10.1111/jdv.14888
9. U.S. Food and Drug Administration. ADBRY™ (tralokinumab-ldrm) injection, for subcutaneous use. Accessed 12 July, 2022. https://mc-df05ef79-e68e-4c65-8ea2-953494-cdn-endpoint.azureedge.net/-/media/corporatecommunications/us/therapeutic-expertise/our-product/adbrypi.pdf?rev=65a4030a7140473198c24e795b9c19f1
10. Silverberg JI, Toth D, Bieber T, et al. Tralokinumab plus topical corticosteroids for the treatment of moderate-to-severe atopic dermatitis: results from the double-blind, randomized, multicentre, placebo-controlled phase III ECZTRA 3 trial. Br J Dermatol. Mar 2021;184(3):450-463. doi:10.1111/bjd.19573
11. Chiesa Fuxench ZC, Block JK, Boguniewicz M, et al. Atopic Dermatitis in America Study: A Cross-Sectional Study Examining the Prevalence and Disease Burden of Atopic Dermatitis in the US Adult Population. J Invest Dermatol. Mar 2019;139(3):583-590. doi:10.1016/j.jid.2018.08.028
12. Yu B, Gastwirth JL. A method of assessing the sensitivity of the Cochran-Mantel-Haenszel test to an unobserved confounder. Philos Trans A Math Phys Eng Sci. Jul 13 2008;366(1874):2377-88. doi:10.1098/rsta.2008.0030