Short-Term Efficacy of Lebrikizumab Versus Dupilumab in Combination with Topical Corticosteroids in Adults with Moderate-to-Severe Atopic Dermatitis: Matching-Adjusted Indirect Comparison

Abstract

Abstract Introduction A matching-adjusted indirect comparison evaluated the short-term efficacy of lebrikizumab plus topical corticosteroids (TCS) versus dupilumab plus TCS in adults with moderate-to-severe atopic dermatitis (AD). Methods Individual patient data from the ADhere trial (lebrikizumab 250 mg every 2 weeks [Q2W] plus TCS) and aggregate data from the CHRONOS trial (dupilumab 300 mg Q2W plus TCS) were matched using the method of moments approach to adjust baseline differences. Matching was done at the study level (primary analysis) and at the study arm level (sensitivity analysis). Efficacy endpoints up to week 16 included the proportion of patients achieving an Investigator’s Global Assessment of 0 or 1 (IGA 0/1); a ≥ 50%, ≥ 75%, and ≥ 90% improvement from baseline in the Eczema Area and Severity Index (EASI 50/75/90); a ≥ 4-point improvement from baseline in the Pruritus Numerical Rating Scale score (PNRS ≥ 4); and a ≥ 4-point improvement from baseline in the Dermatology Life Quality Index score (DLQI ≥ 4). Placebo-adjusted efficacy outcomes were compared using odds ratios (ORs), risk ratios (RRs), and risk differences (RDs) with 95% confidence intervals (CIs). Results At week 16, lebrikizumab plus TCS had comparable odds to dupilumab plus TCS of achieving EASI 75 (OR 1.14, 95% CI 0.42–3.09), IGA 0/1 (OR 1.39, 95% CI 0.42–4.59), PNRS ≥ 4 (OR 0.48, 95% CI 0.17–1.37), and DLQI ≥ 4 (OR 0.89, 95% CI 0.29–2.69). At earlier timepoints, lebrikizumab plus TCS had comparable odds to dupilumab plus TCS of achieving PNRS ≥ 4 at week 2 (OR 2.04, 95% CI 0.24–17.05) and week 4 (OR 3.59, 95% CI 0.90–14.36). RR and RD estimates were consistent with OR estimates of efficacy. Sensitivity analyses confirmed the findings of the primary analysis. Conclusion Lebrikizumab plus TCS was comparable to dupilumab plus TCS across all efficacy endpoints at week 16.