Introduction <p>Dupilumab and lebrikizumab have demonstrated efficacy in atopic dermatitis (AD) clinical trials; however, no direct comparisons exist.</p> Methods <p>Efficacy outcome achievement (dupilumab and lebrikizumab with topical corticosteroids [TCS]) at 16&#xa0;weeks and efficacy outcomes maintenance (dupilumab and lebrikizumab monotherapy without TCS) at 52&#xa0;weeks were assessed using a placebo-adjusted Bucher indirect treatment comparison (ITC). Week 16 data were sourced from LIBERTY AD CHRONOS (dupilumab, <i>n</i> = 106; placebo, <i>n</i> = 315) and ADhere (lebrikizumab, <i>n</i> = 145; placebo, <i>n</i> = 66) trials. Week 52 data were sourced from SOLO-CONTINUE (dupilumab, <i>n</i> = 80; placebo, <i>n</i> = 39) and ADvocate 1 and 2 (lebrikizumab, <i>n</i> = 231; placebo, <i>n</i> = 60) trials, including patients who had achieved ≥ 75% improvement from baseline in Eczema Area and Severity Index (EASI)-75 or Investigator’s Global Assessment (IGA) score 0/1 (clear/almost clear) at week 16. Results are presented as odds ratios (ORs) with 95% confidence intervals (CIs).</p> Results <p>At week 16, patients receiving dupilumab every 2&#xa0;weeks (q2w) + TCS had a significantly higher likelihood of achieving EASI-75 (OR 2.4; 95% CI 1.1–5.1) and a ≥ 4-point improvement in Peak Pruritus Numeric Rating Scale (PP-NRS; OR 2.7; 95% CI 1.2–6.0) versus those receiving lebrikizumab q2w + TCS. ORs for other endpoints (IGA-0/1 and ≥ 4-point improvement in Dermatology Life Quality Index) numerically favored dupilumab.</p> <p>At week 52, dupilumab q2w maintained a significantly higher OR for EASI-75 (OR 3.5; 95% CI 1.2–10.5) versus lebrikizumab every 4&#xa0;weeks. ORs for EASI-90 (OR 3.3; 95% CI 1.0–11.3), IGA 0/1 (OR 3.3; 95% CI 0.7–15.1), and PP-NRS (OR 8.8; 95% CI 0.9–84.8) numerically favored dupilumab.</p> Conclusions <p>Placebo-adjusted Bucher ITC analyses showed that the likelihood of achieving efficacy outcomes at 16&#xa0;weeks and maintaining efficacy outcomes at 52&#xa0;weeks was higher for dupilumab versus lebrikizumab recipients.</p> Graphical Abstract <p></p>

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Dupilumab versus Lebrikizumab Demonstrates Greater Likelihood of Achieving and Maintaining Improvements in Efficacy Outcomes Using a Placebo-Adjusted Indirect Treatment Comparison

  • Sonja Ständer,
  • Andreas Pinter,
  • Firas G. Hougeir,
  • Patricia Guyot,
  • Yingxin Xu,
  • Amy H. Praestgaard,
  • Nick Freemantle,
  • Ana B. Rossi,
  • Gaëlle Bégo-Le-Bagousse,
  • Zhixiao Wang,
  • Kerry Noonan,
  • Mike Bastian

摘要

Introduction

Dupilumab and lebrikizumab have demonstrated efficacy in atopic dermatitis (AD) clinical trials; however, no direct comparisons exist.

Methods

Efficacy outcome achievement (dupilumab and lebrikizumab with topical corticosteroids [TCS]) at 16 weeks and efficacy outcomes maintenance (dupilumab and lebrikizumab monotherapy without TCS) at 52 weeks were assessed using a placebo-adjusted Bucher indirect treatment comparison (ITC). Week 16 data were sourced from LIBERTY AD CHRONOS (dupilumab, n = 106; placebo, n = 315) and ADhere (lebrikizumab, n = 145; placebo, n = 66) trials. Week 52 data were sourced from SOLO-CONTINUE (dupilumab, n = 80; placebo, n = 39) and ADvocate 1 and 2 (lebrikizumab, n = 231; placebo, n = 60) trials, including patients who had achieved ≥ 75% improvement from baseline in Eczema Area and Severity Index (EASI)-75 or Investigator’s Global Assessment (IGA) score 0/1 (clear/almost clear) at week 16. Results are presented as odds ratios (ORs) with 95% confidence intervals (CIs).

Results

At week 16, patients receiving dupilumab every 2 weeks (q2w) + TCS had a significantly higher likelihood of achieving EASI-75 (OR 2.4; 95% CI 1.1–5.1) and a ≥ 4-point improvement in Peak Pruritus Numeric Rating Scale (PP-NRS; OR 2.7; 95% CI 1.2–6.0) versus those receiving lebrikizumab q2w + TCS. ORs for other endpoints (IGA-0/1 and ≥ 4-point improvement in Dermatology Life Quality Index) numerically favored dupilumab.

At week 52, dupilumab q2w maintained a significantly higher OR for EASI-75 (OR 3.5; 95% CI 1.2–10.5) versus lebrikizumab every 4 weeks. ORs for EASI-90 (OR 3.3; 95% CI 1.0–11.3), IGA 0/1 (OR 3.3; 95% CI 0.7–15.1), and PP-NRS (OR 8.8; 95% CI 0.9–84.8) numerically favored dupilumab.

Conclusions

Placebo-adjusted Bucher ITC analyses showed that the likelihood of achieving efficacy outcomes at 16 weeks and maintaining efficacy outcomes at 52 weeks was higher for dupilumab versus lebrikizumab recipients.

Graphical Abstract