Real‑World Experience of 1 Year of Tralokinumab Treatment in Adult Patients with Atopic Dermatitis: A Single-Center Retrospective Study

Abstract

Introduction: Atopic dermatitis (AD) is a chronic inflammatory disease requiring long-term management. Biologic therapies have emerged as systemic treatment options for AD, and real-world evidence (RWE) of their use is needed to inform optimal treatment decisions.

Methods: A retrospective, single-center case series was conducted including 37 adults with AD who were systemic-naive or inadequately responded to previous AD treatment and had a visit around 1 year after tralokinumab initiation prior to May 2024. Patient demographics, disease characteristics, and treatment history were collected. Outcomes of tralokinumab treatment, including investigator's global assessment (IGA) score, body surface area (BSA), and adverse events (AEs), were extracted from a 2-month visit (defined as 1-3 months) and a 1-year visit (defined as ≥ 10 months) after tralokinumab initiation.

Results: Thirty-seven patients (median age, 58.0 years; 49% male) on tralokinumab for approximately 1 year or longer were included. At baseline, most patients (97% [33/34]) had moderate-to-severe AD (IGA 3 or 4), and median (interquartile range [IQR]) BSA was 10.0% (5.0%; 18.8%); 19% (7/37) of patients were biologic-experienced, having been previously on dupilumab. Most patients (95% [35/37]) transitioned to tralokinumab due to inadequate response to previous treatment. The proportion of patients with IGA score 0 or 1 increased from 0% (0/34) at baseline to 85% (22/26) after 2 months and 93% (28/30) at 1 year of tralokinumab treatment. Median (IQR) BSA improved to 0.5% (0.0%; 1.0%) and 0.0% (0.0%; 1.0%) at the 2-month and 1-year visits, respectively. Similar improvements were observed regardless of Fitzpatrick skin type or previous treatment history. No AEs were reported through 1 year of follow-up.

Conclusions: This large case series provides RWE building on tralokinumab clinical trial data and highlights the potential rapid and long-term response in patients with AD irrespective of their Fitzpatrick skin type or treatment history, including patients previously treated with dupilumab.

Keywords: Atopic dermatitis; Biologic therapies; Dupilumab; Real-world evidence; Tralokinumab.

Fig. 1

IGA severity distribution and median BSA after approximately 1 year of tralokinumab treatment for a, b all patients, and stratified by c, d Fitzpatrick skin type and e, f previous biologic treatment. Tralokinumab outcome data were extracted from a 2-month visit (defined as 1–3 months) and a 1-year visit (defined as at least 10 months) after tralokinumab initiation. Error bars represent IQR. BSA body surface area, Exp experienced, IGA investigator’s global assessment, IQR interquartile range, n number of patients

Fig. 2

Improvement in signs of AD after tralokinumab initiation. Time of photographs relative to date of tralokinumab initiation. Photographs taken during routine clinical practice. Patients provided informed consent to publish photographs. BSA body surface area, IGA Investigator’s Global Assessment, t time