The FDA has approved Eli Lilly’s Ebglyss (lebrikizumab-lbkz) for the treatment of moderate-to-severe atopic dermatitis (eczema) in adult and pediatric patients (12 years and older weighing at least 88 lbs) whose disease is not adequately controlled with topical prescription therapies. This approval marks a significant advancement in the treatment landscape for atopic dermatitis, offering a new first-line biologic option for patients.
Targeting IL-13 in Atopic Dermatitis
Ebglyss is a biologic therapy designed to specifically target the interleukin (IL)-13 pathway, a key driver of systemic inflammation implicated in the pathophysiology of atopic dermatitis. By selectively blocking IL-13, Ebglyss aims to reduce the inflammation that leads to the characteristic dry, itchy, and irritated skin associated with eczema.
Clinical Trial Efficacy
The FDA approval was based on data from three pivotal Phase III clinical trials: ADvocate 1, ADvocate 2, and ADhere. ADvocate 1 and ADvocate 2 were 52-week, randomized, double-blind, placebo-controlled studies evaluating Ebglyss as a monotherapy. Patients received Ebglyss 500 mg initially and at two weeks, followed by 250 mg or placebo every two weeks. Responders at 16 weeks were re-randomized to receive Ebglyss every two weeks, every four weeks, or placebo for an additional 36 weeks. The primary endpoint was a reduction of at least two points on the Investigator Global Assessment (IGA) score from baseline at 16 weeks.
Adhere was a 16-week randomized, double-blind, placebo-controlled study assessing Ebglyss in combination with topical corticosteroids in patients with moderate-to-severe eczema inadequately controlled by topical medications alone.
Results from the Advocate studies showed that 38% of patients achieved clear or almost-clear skin at 16 weeks, compared to 12% on placebo. Furthermore, 77% of patients who responded to treatment maintained these results for up to one year with monthly dosing. Significant itch relief was reported by 43% of patients by week 16, compared to 12% on placebo, with 85% maintaining relief after one year of treatment.
Safety Profile and Adverse Events
Common adverse events associated with Ebglyss included eye and eyelid inflammation (redness, swelling, itching), injection site reactions, and shingles. The prescribing information includes a warning against use in individuals with known allergy to lebrikizumab-lbkz or any of its ingredients. The safety profile during maintenance treatment remained consistent across the clinical studies.
Addressing Unmet Needs in Atopic Dermatitis
Atopic dermatitis affects approximately 7.3% of adults in the US, with 40% experiencing moderate to severe symptoms. These symptoms can significantly impact patients' quality of life. "Patients still struggle to control their moderate-to-severe atopic dermatitis with currently available therapies. Many experience poor long-term disease control, and severe itch can significantly impact their daily lives," said Jonathan Silverberg, MD, PhD, MPH, professor of dermatology, George Washington University School of Medicine and Health Sciences. "Today's FDA approval of Ebglyss is a big win for patients, as we now have a new first-line biologic treatment option for moderate-to-severe disease when topical prescriptions aren't enough."
