Breaking Down Biologics in Atopic Dermatitis: Choosing the Right Path for Patients - Episode 6

Evaluating Biologic Treatment as Monotherapy for Atopic Dermatitis

Published on: April 7, 2025

Melodie Young, MSN, A/GNP-C, FSDNP, DCNP , TJ Chao, MPAS, PA-C, Leigh Ann Pansch, MSN, FNP-BC, DCNP , Douglas DiRuggiero, DMSc, MHS, PA-C

Panelists discuss how pivotal clinical trials for atopic dermatitis biologics demonstrate both rapid and durable efficacy as monotherapy, with 3 agents—dupilumab (SOLO 1/2), lebrikizumab (ADvocate 1/2), and tralokinumab (ECZTRA 1/2)—achieving significantly higher rates of clear/almost clear skin (IGA 0/1) at week 16 vs placebo; early itch improvement by week 2; and, importantly, sustained response among initial responders at week 52, with maintenance rates varying across therapies: 50% to 70.6% for dupilumab at week 36, 74% for lebrikizumab at week 52, and 39% to 59% for tralokinumab at week 52 (statistically significant only in ECZTRA 2).

EP. 1: Assessing Atopic Dermatitis Severity in Clinical Practice

EP. 2: Establishing Atopic Dermatitis Treatment Goals and Expectations With Patients

EP. 3: Moving Beyond Topical Treatments in Atopic Dermatitis Management

EP. 4: The Evolving Landscape for Atopic Dermatitis Treatment

EP. 5: Overview of the Biologics Approved in Atopic Dermatitis

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EP. 6: Evaluating Biologic Treatment as Monotherapy for Atopic Dermatitis

Video content above is prompted by the following:

Studies of the biologics in atopic dermatitis have shown that patients are able to achieve clear or almost clear skin when using biologics as monotherapy. What have these studies shown about the ability to maintain clear skin in the long term?
Dupilumab (SOLO 1 and 2)
Significantly more patients achieved clear or almost clear skin (IGA 0/1) at week 16 with dupilumab compared with placebo.
By week 2, patient-reported itch scores were significantly better for patients on dupilumab than placebo.
Among IGA 0/1 responders, 50% to 70.6% of patients on dupilumab were able to maintain an IGA 0/1 at week 36 (Worm, 2019).
Lebrikizumab (ADvocate 1 and 2)
Significantly more patients were able to achieve clear or almost clear skin (IGA 0/1) at week 16 with lebrikizumab compared with placebo.
Approximately 10% of patients were able to achieve clear or almost clear skin at week 4.
By week 2, patient-reported itch scores were significantly better for patients on lebrikizumab than placebo in ADvocate 1.
Among IGA 0/1 responders, 74% of patients on lebrikizumab maintained an IGA 0/1 at week 52 (Blauvelt, 2023).
Tralokinumab (ECZTRA 1 and 2)
Significantly more patients were able to achieve clear or almost clear skin (IGA 0/1) at week 16 with tralokinumab compared with placebo.
Among IGA 0/1 responders, 39% to 59% of patients on tralokinumab maintained an IGA 0/1 at week 52 (results only statistically significant in ECZTRA 2).