New data from the ADvocate1 and ADvocate2 clinical trials reveal that continuing lebrikizumab treatment can provide substantial benefits for moderate-to-severe atopic dermatitis patients, even when initial response targets are not met at 16 weeks.
The analysis focused on patients who received lebrikizumab every two weeks during the induction period but did not achieve the protocol-defined response criteria of either a 75% improvement in the Eczema Area and Severity Index (EASI 75) or an Investigator Global Assessment (IGA) score of 0/1 with ≥2-point improvement, without rescue medication.
Extended Treatment Yields Impressive Results
While 38.1% of lebrikizumab-treated patients initially entered the escape arm at week 16, the majority (58.1%) had already shown meaningful improvement with at least 50% reduction in EASI scores. More importantly, by week 52, the clinical benefits became more pronounced:
- 75.5% of patients achieved EASI 75
- 44.2% reached EASI 90
- 36.1% attained IGA 0/1 with ≥2-point improvement
- 66.4% reported significant itch relief with ≥4-point improvement on the Pruritus Numeric Rating Scale
Clinical Implications
These findings carry significant implications for clinical practice, suggesting that physicians should consider maintaining lebrikizumab treatment even when patients don't meet initial response criteria. The progressive improvement in efficacy measures indicates that some patients may require longer treatment duration to achieve optimal results.
The study allowed concomitant topical therapy during the open-label treatment period, reflecting real-world clinical practice conditions. While this aspect should be considered when interpreting the results, the substantial improvements across multiple efficacy measures support the potential value of extended lebrikizumab treatment.
Patient Response Patterns
The data reveals an important pattern in patient response to lebrikizumab: while some patients may not achieve the stringent protocol-defined responses early in treatment, continued therapy can lead to significant clinical improvements. This observation is particularly relevant for managing patient expectations and making informed decisions about treatment continuation.
The marked improvement in pruritus scores is especially noteworthy, as itch represents one of the most bothersome symptoms for atopic dermatitis patients, significantly impacting quality of life. The fact that two-thirds of patients achieved substantial itch relief by week 52 underscores the clinical value of sustained treatment.
