Abstract Rationale Atopic dermatitis (AD) is a chronic skin disease associated with atopic comorbidities such as asthma, and interleukin-13 is a dominant cytokine in both Th2-driven diseases. Although approved only for the treatment of AD and not asthma, lebrikizumab (LEB), an interleukin-13 inhibitor, has shown meaningful improvements in exacerbation rates and lung function in post-hoc analyses of uncontrolled (high type-2) asthma. AD-LIFE is a non-interventional study of LEB in patients with moderate-to-severe AD in Germany, allowing enrollment of patients with comorbid asthma. We report interim AD-LIFE results on asthma control in patients with moderate-to-severe AD and comorbid asthma, and compare AD outcomes by patient-reported asthma status in a real-world setting. Methods Patients received subcutaneous LEB in routine clinical practice, prescribed in line with the summary of product characteristics. Asthma control was assessed using the Asthma Control Questionnaire (ACQ-5; observed cases OC), evaluating mean scores and the proportion of patients with scores indicating uncontrolled (1.5), moderately controlled (0.75-1.5), and controlled asthma (0.75) at baseline and week (W)16. The proportion achieving clinically meaningful ≥0.5 point improvement in ACQ-5 at W16 versus baseline is also reported. AD outcomes include the percentage of patients achieving Eczema Area and Severity Index (EASI)75/90 (≥75%/≥90% improvement from baseline; OC), and ≥4-point improvement in Peak Pruritus-Numerical Rating Scale (PP-NRS; OC) at W16. Results 100 patients were included; 40 with comorbid asthma (WCA) self-reported at baseline and 60 without comorbid asthma (WOCA). Baseline characteristics (WCA/WOCA): 60%/55.0% female; age (mean±standard deviation) 42.9±14.0/40.2±15.6 years; mean EASI 23.7±12.7/20.2±10.5; mean Pruritus-NRS 7.1±2.3/7.3±1.9. At baseline, 62.5% of patients WCA had ≥1 concomitant asthma medication. Among patients WCA, mean ACQ-5 score decreased (i.e. improved) from 1.4 (baseline) to 0.8 (W16; p 0.01). The percentage of patients achieving asthma control was greater at W16 (58.8%) versus baseline (31.6%), while uncontrolled (baseline/W16: 42.1%/26.5%) and moderately controlled asthma (26.3%/14.7%) were less frequent at W16. Clinically meaningful ACQ-5 improvements from baseline were seen in 14/34 (41.2%; 95% CI: 24.6-59.3) patients WCA. At W16, EASI75 and EASI90 were achieved by 64.9%/61.8% (WCA/WOCA) and 32.4%/32.7% of patients, respectively. PP-NRS ≥4-point improvement was achieved by 55.6%/64.4% of patients WCA/WOCA, respectively. Conclusions Patients with moderate-to-severe AD and comorbid asthma may experience clinically meaningful improvements in self-reported asthma symptoms with LEB treatment, alongside effective AD management at W16. Results are limited by changes in concomitant asthma medications and physician-assessed asthma severity not being examined. This abstract is funded by: Almirall Hermal GmbH
Buhl et al. (Fri,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: