Lebrikizumab matches up to dupilumab for atopic dermatitis in adults

Lebrikizumab and dupilumab appear to be equally efficacious when used in the short-term treatment of atopic dermatitis in adults, according to the results of a network meta-analysis.

Researchers searched multiple online databases for randomized clinical trials wherein treatment with systemic immunomodulatory medications for at least 8 weeks was evaluated in patients with moderate-to-severe atopic dermatitis.

A total of 98 trials involving 24,707 patients were included in the network meta-analysis. Random-effects Bayesian network meta-analyses were performed, and the certainty of evidence was evaluated using the GRADE approach.

No significant differences in changes in several efficacy outcome measures were seen between lebrikizumab and dupilumab groups over 16 weeks of treatment. This was true for Eczema Area and Severity Index (EASI; mean difference [MD], −2.0, 95 percent credible interval [CrI], −4.5 to 0.3; moderate certainty), Patient Oriented Eczema Measure (POEM; MD, −1.1, 95 percent CrI, −2.5 to 0.2; moderate certainty), Dermatology Life Quality Index (DLQI; MD, −0.2, 95 percent CrI, −2.1 to 1.6; moderate certainty), or Peak Pruritus Numeric Rating Scales (PP-NRS; MD, 0.1, 95 percent CrI, −0.4 to 0.6; high certainty).

The odds of efficacy in binary outcomes were greater with dupilumab than with lebrikizumab. Meanwhile, the relative efficacy of other approved systemic medications remained consistent with previous findings, with high-dose upadacitinib and abrocitinib demonstrating numerically highest efficacy.

As for safety, low adverse event rates precluded useful comparisons.