D2.248 - Asthma control in patients with moderate-to-severe atopic dermatitis and comorbid-asthma treated with lebrikizumab in a real-world-setting: interim analysis of the non-interventional study ADLife

Atopic dermatitis (AD) is associated with asthma. Although approved only for the treatment of AD and not asthma, post-hoc lebrikizumab (LEB) analyses showed improvements in lung function and exacerbation rates in patients with high type-2 (uncontrolled) asthma. However, the impact of LEB on mild-to-moderate comorbid asthma in AD patients (pts) remains scarce. We report interim effectiveness data from the non-interventional study ADLife for moderate-to-severe AD patients with or without comorbid asthma (WCA/WOCA).

Patients were ≥18 years, with moderate-to-severe AD requiring systemic therapy, who received LEB treatment per label according to physician’s decision and provided informed consent. Effectiveness outcomes included percent (%) change from baseline (CfB) in Eczema Area and Severity Index (EASI), 24 hour-peak Pruritus-Numerical Rating Scale (peak P-NRS) at Week (W)4/W16; patient-reported Sleep-Loss Scale and ≥75%/90% improvement in EASI (EASI75/90) at W16. Asthma control was assessed using the Asthma Control Questionnaire (ACQ-5) at baseline (BL)/W16. Data reported as observed.

100 patients were included (40 WCA self-reported at baseline, 60 WOCA). Overall BL characteristics: mean (SD) age of 41.3 (15.0) years and 57% were female; severity: mean (SD) scores of EASI 21.6 (11.5), peak P-NRS 7.2 (2.1). Baseline characteristics for patients WCA/WOCA: mean (SD) age 42.9 (14.0)/40.2 (15.6) years, 60.0%/55.0% female, EASI 23.7 (12.7)/20.2 (10.5), P-NRS 7.1 (2.3)/7.3 (1.9). At W4/W16, % CfB in EASI was −53.8%/−70.1% (both p<0.0001) and Peak P-NRS was −44.0%/−52.5% (both p<0.0001). Sleep-loss % CfB at W16 was −53.1% (p<0.0001). Among patients WCA, the mean ACQ-5 score decreased (i.e. improved) from 1.4 (BL) to 0.8 (W16; p<0.01). The % of patients achieving asthma control increased at W16 vs BL (BL/W16): 42.1%/26.5% WCA had uncontrolled asthma, 26.3%/14.7% moderately controlled asthma and 31.6%/58.8% controlled asthma. A clinically meaningful improvement at W16 (defined as ≥0.5 in ACQ-5 score) vs BL was reported in 14/34 (41.2%) patients WCA (95% CI: 24.6−59.3). The % patients achieving EASI75 (WCA/WOCA) at W16 was 64.9%/61.8%; EASI90: 32.4%/32.7%.

These findings suggest that patients with moderate-to-severe AD and comorbid asthma may experience clinical improvement in asthma-symptoms with LEB at W16, while showing high efficacy in AD, seen as early as W4.