Review of Tralokinumab in the Treatment of Atopic Dermatitis.

Abstract

OBJECTIVE:

To review pharmacokinetics, efficacy, and safety of tralokinumab in treatment of atopic dermatitis (AD).

DATA SOURCES:

Literature review was conducted using MEDLINE (PubMed), EMBASE, and ClinicalTrials.gov for articles published between January 2010 and May 2022.

STUDY SELECTION AND DATA EXTRACTION:

Articles in English discussing tralokinumab in AD were included.

DATA SYNTHESIS:

In one phase 2 trial, more subjects treated with tralokinumab 150 and 300 mg achieved an Investigator's Global Assessment (IGA) of 0/1 with minimum ≥2 point IGA reduction (23%), versus placebo (11.8%, P = 0.10). During 2 phase 3 trials, more subjects treated with tralokinumab achieved IGA success (ECZTRA 1: 15.8% and ECZTRA 2: 22.2%), versus placebo (7.1% and 10.9%, respectively; P = 0.002 and P < 0.001). During one phase 3 trial, in conjunction with topical corticosteroids (TCS), more subjects treated with tralokinumab 300 mg achieved IGA success (ECZTRA 3: 38.9%), versus placebo (26.2%, P = 0.015). During another phase 3 trial in subjects with resistance or contraindication to oral cyclosporine, more subjects treated with tralokinumab 300 mg achieved an Eczema Area Severity Index 75 (64.2%), versus placebo (50.5%, P = 0.018).

RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE:

Tralokinumab is efficacious for moderate-to-severe AD, as monotherapy, in conjunction with TCS, and resistance or contraindication to cyclosporine. Although IL-4 and IL-13 are both implicated in AD's pathogenesis, IL-13 is overexpressed, and head-to-head trials are needed to assess efficacy of tralokinumab, versus dupilumab. Compared with upadacitinib and abrocitinib, tralokinumab is not associated with black-box warnings.

CONCLUSIONS:

Tralokinumab is an efficacious and safe systemic treatment for moderate-to-severe AD.

• Authors: Rohan Singh, Alexandra Taylor, Milaan A Shah, Lindsay C Strowd, Steven R Feldman
• Journal: The Annals of pharmacotherapy (Ann Pharmacother) Vol. 57 Issue 3 Pg. 333-340 (03 2023) ISSN: 1542-6270 [Electronic] United States
• PMID: 35730479 (Publication Type: Journal Article, Review)

Chemical References

• tralokinumab
• Interleukin-13
• Glucocorticoids
• Cyclosporine
• Dermatologic Agents
• Immunoglobulin A

Topics

• Humans
• Dermatitis, Atopic (drug therapy, complications, pathology)
• Interleukin-13 (therapeutic use)
• Treatment Outcome
• Double-Blind Method
• Severity of Illness Index
• Glucocorticoids (therapeutic use)
• Cyclosporine (therapeutic use)
• Dermatologic Agents (therapeutic use)
• Immunoglobulin A (therapeutic use)