Real‐life case‐series experience with tralokinumab in patients with severe atopic dermatitis

Abstract

AbstractAtopic dermatitis (AD) is an inflammatory chronic recurrent skin condition that causes recurrent, itching eczematous lesions with a great impact on the quality of life of patients. We describe a case series of five adult patients with severe AD (Eczema Area Severity Index [EASI] ≥24) treated with tralokinumab. Tralokinumab is a monoclonal antibody that specifically binds IL‐13 with high affinity, blocking the interaction of IL‐13 with its specific receptors and neutralising its biological activity. Tralokinumab was recently approved for the treatment of moderate‐to‐severe AD in adults. In these patients, several conventional topical and systemic treatments (such as UV‐B phototherapy, systemic cyclosporine and dupilumab) had been previously tried. Three patients reported severe conjunctivitis during the previous treatment with dupilumab and one patient had not a good clinical response to dupilumab, as this treatment was stopped. Therefore, treatment with tralokinumab as a subcutaneous injection at an initial dose of 600 mg followed by 300 mg administered every other week was started. The severity of AD was assessed at baseline, Week 12 and Week 20 using several clinical scores (EASI, SCOring Atopic Dermatitis, Itch score, Dermatology Life Quality Index). All patients achieved clinical remission with a significant clinical improvement of itching and eczema in all body areas, assessed with several clinical scores; furthermore, no adverse events were reported during the observation period. During the treatment with tralokinumab, one patient was also infected by the SARS‐CoV‐2 virus, reporting mild clinical symptoms of the upper respiratory tract. These symptoms spontaneously resolved in 2 days with no medications. Although additional real‐world data are certainly required about the efficacy and safety of tralokinumab, the prospects of new drugs for the long‐term treatment of moderate‐to‐severe AD represent a great opportunity for these patients, which had very few therapeutic options until now.