Lebrikizumab Improves Patient-Reported Outcomes in Atopic Dermatitis for Patients Previously Treated with Dupilumab

Findings from a new phase 3b study presented at the 2025 American Academy of Dermatology (AAD) meeting demonstrated that that lebrikizumab (EBGLYSS; Lilly), a monoclonal antibody targeting interleukin-13, significantly improves itch, itch interference with sleep, and skin pain in patients with moderate-to-severe atopic dermatitis (AD) who had been previously treated with dupilumab (Dupixent; Sanofi and Regeneron). These findings indicate that lebrikizumab may provide an effective alternative for AD patients with persistent symptoms despite prior biologic therapy.

Gil Yosipovitch, MD

Lebrikizumab improved itch, a predominant symptom of AD, in phase 3 registration trials. The open-label phase 3b further explored the efficacy in those who had not seen improvement during treatment with dupilumab.

The ADapt trial (NCT05369403), led by Gil Yosipovitch, MD, professor of dermatology at the Miller School of Medicine at University of Miami, and Director of the Miami Itch Center, was an open-label, 24-week study evaluating the efficacy of lebrikizumab in adults and adolescents who discontinued dupilumab due to inadequate response (56%), intolerance or adverse events (16%), or other reasons (28%). Participants received lebrikizumab 250 mg every two weeks (LEBQ2W) until week 16. Those achieving an Investigator’s Global Assessment (IGA) score of 0/1 with a 2-point or greater improvement or an Eczema Area and Severity Index (EASI-75) response transitioned to a 4-week dosing schedule (LEBQ4W) until week 24. Participants who did not meet these criteria continued LEBQ2W.

By weeks 16 and 24, the majority of participants demonstrated marked symptom improvements. The proportion achieving a Pruritus Numeric Rating Scale (PNRS) improvement of 3 points or greater was 72.9% at week 16 and 77.5% at week 24. Further, the percentage of the study cohort that achieved a 4 point or greater PNRS improvement increased from 53.2% at week 16 to 61.5% at week 24.

Sleep interference, a significant issue related to itch in AD, also improved, with 41.7% of patients achieving a 2 point or greater Sleep-Loss Scale improvement at week 16 and 42.1% at week 24. Skin pain, measured by the Skin Pain NRS, showed substantial reduction, with 58.8% of patients achieving at least a 4-point improvement at week 16, increasing to 75.0% at week 24.

Among those who discontinued dupilumab due to inadequate response, 65.2% achieved a improvement of 3 points or more on the PNRS, while 50.0% reached a 4 point or greater improvement at week 16.

The FDA approved lebrikizumab in September 2024 for adults and children aged 12 years and older with moderate to severe atopic dermatitis (AD) not controlled by topical therapies.2

The selective IL-13 inhibitor is indicated for treatment of adults and of pediatric patients who weigh at least 88 pounds (40 kg) and can be used with or without topical corticosteroids, according to Lilly.2

References:

1. Yosipovitch G, Ackerman L, Bagel J, et al. Lebrikizumab improves itch, itch interference on sleep, and skin pain in patients with moderate-to-severe atopic dermatitis previously treated with dupilumab. Poster. Presented at: The 2025 American Academy of Dermatology Annual Meeting. Orlando, Florida.

2. FDA approves Lilly's Ebglyss (lebrikizumab-lbkz) for adults and children 12 years and older with moderate-to-severe atopic dermatitis. News release. Lilly. September 13, 2024. Accessed September 16, 2024. https://investor.lilly.com/news-releases/news-release-details/fda-approves-lillys-ebglysstm-lebrikizumab-lbkz-adults-and