Matching-Adjusted Indirect Comparison of the Efficacy of Tralokinumab and Dupilumab in the Treatment of Moderate-to-Severe Atopic Dermatitis Beyond Week 16

Abstract

Introduction: Tralokinumab and dupilumab are both licensed for the treatment of moderate-to-severe AD. However, to date no head-to-head studies or indirect comparisons of their efficacy beyond week 16 have been conducted.
 Objective: To conduct a matching-adjusted indirect comparison (MAIC) comparing the efficacy of tralokinumab and dupilumab beyond week 16, both used in combination with topical corticosteroids.
 Methods: An unanchored MAIC was conducted using individual patient data (IPD) from the ECZTRA 3 tralokinumab trial and aggregate data from the LIBERTY AD CHRONOS dupilumab trial. IPD were selected by applying the inclusion criteria from the LIBERTY AD CHRONOS trial, then weighted to match summary baseline characteristics – age, sex, race, BMI, disease duration, EASI, DLQI, IGA and SCORAD– of patients treated with dupilumab. Tralokinumab efficacy outcomes at week 32 were compared with dupilumab data at week 32 (EASI and IGA only) and week 52.
 Results: Baseline characteristics of the matched tralokinumab arm were well balanced with the dupilumab arm. Tralokinumab and dupilumab showed comparable efficacy across all endpoints. The matched proportions of patients achieving IGA 0/1 were larger for tralokinumab patients at week 32 (49.9%) compared with dupilumab patients at week 32 (39.3%) and week 52 (36.0%). The matched differences in IGA 0/1 at weeks 32 and 52 were 10.6% (95% CI: −2.9%, 24.0%; p = 0.12) and 13.9% (95% CI: 0.6%, 27.3%; p = 0.04), respectively. For EASI 75, the proportion of responders was equivalent for tralokinumab and dupilumab (both 71.9%) at week 32 (difference 0%; 95% CI: −12.2%, 12.3%; p = 1.00). The proportion of EASI 75 responders was numerically lower for dupilumab (65.2%) at week 52 compared with tralokinumab at week 32, giving a difference of 6.8% (95% CI: −5.9%, 19.5%; p = 0.3).
 Conclusion: These results confirm broadly similar efficacy for tralokinumab and dupilumab beyond week 16.