Predictive Factors for Poor Responders to Tralokinumab in Moderate-to-Severe Atopic Dermatitis: A Real-World Analysis

Abstracts:Background: Some patients with moderate-to-severe atopic dermatitis (AD) show insufficient response to treatment with tralokinumab, an anti-interleukin-13 antibody. Identifying predictive factors for poor responders to tralokinumab can help optimize treatment strategies for AD patients. Objective: To identify predictive factors for poor responders to tralokinumab, defined as an investigator's global assessment >2 at week 12 or 24. Methods: A prospective study was conducted from October 2023 to August 2024, including 109 Japanese patients with moderate-to-severe AD. Baseline features were compared between poor responders versus responders at week 12 or 24. Results: Poor responders at week 12 showed higher baseline eczema area and severity index (EASI), lactate dehydrogenase (LDH), and eosinophil-to-lymphocyte ratio (ELR) compared with responders. Poor responders at week 24 had older age, longer disease duration, and higher proportions of previous systemic therapies, previous dupilumab, or previous 15 mg upadacitinib treatment, compared with responders. Conclusions: Higher baseline EASI, LDH, and ELR may predict poor response to tralokinumab at week 12. Older age, longer disease duration, and previous usage of systemic therapy, dupilumab, or 15 mg upadacitinib may predict poor response to tralokinumab at week 24. AD patients with the above features may as well avoid tralokinumab treatment.