Department of Dermatology and Allergy, Ludwig Maximillian University, Munich, Germany.
Translational Medicine, MedImmune, Gaithersburg, Md.
J Allergy Clin Immunol. 2019 Jan;143(1):135-141. doi: 10.1016/j.jaci.2018.05.029. Epub 2018 Jun 12.
IL-13 has an important role in atopic dermatitis (AD) pathogenesis. Tralokinumab is a fully human mAb that potently and specifically neutralizes IL-13.
We sought to evaluate the efficacy and safety of tralokinumab in adults with moderate-to-severe AD.
In this phase 2b study (NCT02347176), 204 adults were randomized 1:1:1:1 to receive 45, 150, or 300 mg of subcutaneous tralokinumab, or placebo, every 2 weeks for 12 weeks with concomitant topical glucocorticoids. Coprimary end points were change from baseline in Eczema Area Severity Index score and percentage of participants with an Investigator's Global Assessment response (0/1 score and reduction of ≥2 grades from baseline) at week 12.
At week 12, 300 mg of tralokinumab significantly improved change from baseline in Eczema Area Severity Index score versus placebo (adjusted mean difference, -4.94; 95% CI, -8.76 to -1.13; P = .01), and a greater percentage of participants achieved an Investigator's Global Assessment response (26.7% vs 11.8%). Greater responses were found in participants with greater concentrations of biomarkers of increased IL-13 activity. Participants treated with 300 mg of tralokinumab demonstrated improvements in SCORAD, Dermatology Life Quality Index, and pruritus numeric rating scale (7-day mean) scores versus placebo. Upper respiratory tract infection was the most frequent treatment-emergent adverse event reported as related to study drug in the placebo (3.9%) and pooled tralokinumab (3.9%) groups.
Tralokinumab treatment was associated with early and sustained improvements in AD symptoms and an acceptable safety and tolerability profile, thereby providing evidence for targeting IL-13 in patients with AD.
白细胞介素-13(IL-13)在特应性皮炎(AD)发病机制中具有重要作用。特利鲁单抗(tralokinumab)是一种人源化单克隆抗体,能强力且特异性地中和 IL-13。
我们旨在评估特利鲁单抗在中重度 AD 成人患者中的疗效和安全性。
在这项 2b 期研究(NCT02347176)中,204 例成人患者按 1:1:1:1 的比例随机分组,分别接受 45、150 或 300mg 特利鲁单抗或安慰剂,每 2 周皮下注射 1 次,共 12 周,同时外用糖皮质激素。主要疗效终点为第 12 周时从基线变化的湿疹面积严重程度指数(Eczema Area Severity Index,EASI)评分和研究者整体评估(0/1 分和自基线降低≥2 级)应答的参与者比例。
第 12 周时,与安慰剂相比,300mg 特利鲁单抗显著改善了 EASI 评分从基线的变化(调整后的平均差值,-4.94;95%置信区间,-8.76 至-1.13;P =.01),且达到研究者整体评估应答的参与者比例更高(26.7% vs 11.8%)。在生物标志物提示 IL-13 活性增加较多的患者中,观察到更大的应答。接受 300mg 特利鲁单抗治疗的患者在 SCORAD、皮肤病生活质量指数(Dermatology Life Quality Index,DLQI)和瘙痒数字评定量表(7 天平均)评分方面的改善优于安慰剂。最常见的治疗相关不良事件是上呼吸道感染,在安慰剂(3.9%)和特利鲁单抗(3.9%)组中均有报告。
特利鲁单抗治疗与 AD 症状的早期和持续改善相关,安全性和耐受性良好,为 AD 患者靶向治疗 IL-13 提供了证据。