Lebrikizumab for moderate-to-severe atopic dermatitis

A Phase IV, Non-randomized, Open-label Multinational Trial to Assess the Mechanism of Action for Lebrikizumab in Moderate-to-severe Atopic Dermatitis

This study will test whether lebrikizumab gives people with moderate-to-severe atopic dermatitis lasting skin improvement and itch relief.

Quick facts

• Phase: Phase 4
• Study type: Interventional
• Enrollment: 48 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: University of Michigan (Academic / other)
• Drugs / interventions: lebrikizumab, dupilumab, tralokinumab, rituximab, methotrexate
• Locations: 4 sites (Folsom, California and 3 other locations)
• Trial ID: NCT06906497 on ClinicalTrials.gov

What this trial studies

This Phase 4 study gives approved lebrikizumab to eligible participants and collects health information, blood, and skin samples over time to monitor outcomes. Participants must have atopic dermatitis for at least one year with moderate-to-severe disease (IGA 3, >10% BSA, EASI ≥16) and be biologic-naïve. Regular clinical assessments and sample collection are used to document clinical course and to search for biological markers linked to long-term response. The drug is IND-exempt and the focus is on long-term effectiveness and mechanistic insights rather than initial efficacy.

Who should consider this trial

Good fit: Adults with atopic dermatitis for at least one year who have moderate-to-severe disease (IGA 3, >10% BSA, EASI ≥16), pruritus NRS ≥4, are biologic-naïve, and who agree to the study's contraception or abstinence requirements.

Not a fit: People with mild atopic dermatitis, prior biologic therapy, or who cannot comply with contraception/abstinence rules or attend study visits likely will not benefit from participating.

Why it matters

Potential benefit: If successful, patients could experience sustained skin clearing and reduced itching, and the results could guide safer long-term use of lebrikizumab.

How similar studies have performed: Prior randomized trials demonstrated lebrikizumab's ability to improve skin clearance and reduce itch, and the drug is already FDA-approved for atopic dermatitis, so this study builds on established efficacy.

Eligibility criteria

Inclusion Criteria:

* Established diagnosis of AD for at least 1 year before the screening visit and topical treatment was inadequate or inadvisable.
* Moderate-to-severe AD with involvement \> 10% of body-surface-area (BSA) and investigator global assessment (IGA) score =3 (based on the IGA scale ranging from 0 to 4, in which 3 is moderate and 4 is severe) at both the screening and baseline visits.
* Subject has an Eczema Area and Severity Index (EASI) score =16 at screening and baseline.
* Subject has a pruritus NRS =4.
* Subject is biologic naïve.
* Female subjects of childbearing potential (i.e., fertile, following menarche and until becoming post-menopausal unless permanently sterile) must agree either to commit to true abstinence throughout the study and for at least 17 weeks after the last study drug (SD) injection, when this is in line with the preferred and usual lifestyle of the subject, or to use a highly-effective and approved method of contraception throughout the study and for at least 17 weeks after the last study drug injection.
* Subject willing and able to comply with all of the clinical study protocol's time commitments and procedural requirements.
* Understand and sign an informed consent form (ICF) (and assent form, when applicable) before any investigational procedure(s) are performed.

Exclusion Criteria:

* Previous treatment with lebrikizumab or participation in a lebrikizumab study.
* History of anaphylaxis as defined by the Sampson criteria.
* Treatment with topical corticosteroids, calcineurin inhibitors, Jak inhibitors, or crisaborole within 1 week prior to the baseline visit.
* Prior treatment with dupilumab or tralokinumab.
* Treatment with any of the following agents within 4 weeks prior to the baseline visit:

  1. Immunosuppressive/immunomodulating drugs (e.g., systemic corticosteroids, cyclosporine, mycophenolate-mofetil, IFN-., Janus kinase inhibitors (JAKi), azathioprine, methotrexate).
  2. Phototherapy and photochemotherapy (PUVA) for AD.
* Treatment with the following prior to the baseline visit:

  1. An investigational drug within 8 weeks or 5 half-lives (if known), whichever is longer.
  2. Cell-depleting biologics, including to rituximab, within 6 months.
  3. Other biologics within 5 half-lives (if known) or 16 weeks, whichever is longer.
* Use of prescription moisturizers within 7 days of the baseline visit.
* Regular use (more than 2 visits per week) of a tanning booth/parlor within 4 weeks of the screening visit.
* Treatment with a live (attenuated) vaccine within 12 weeks of the baseline visit or planned during the study.
* Uncontrolled chronic disease that might require bursts of oral corticosteroids, e.g., co-morbid severe uncontrolled asthma requiring systemic \[oral and/or parenteral\] corticosteroid treatment or hospitalization for \> 24 hours).
* Active chronic or acute infection requiring treatment with systemic antibiotics, antivirals, anti-parasitics, antiprotozoals, or antifungals within 2 weeks before the baseline visit, or superficial skin infections within 1 week before the baseline visit. NOTE: patients may be rescreened after infection resolves.
* Evidence of active acute or chronic hepatitis (as defined by the Department of Health \& Human Services Centers for Disease Control and Prevention) or known liver cirrhosis.
* Diagnosed active endoparasitic infections or at high risk of these infections.
* Known or suspected history of immunosuppression, including history of invasive opportunistic infections (e.g., tuberculosis \[TB\], histoplasmosis, listeriosis, coccidioidomycosis, pneumocystosis, and aspergillosis) despite infection resolution: or unusually frequent, recurrent, or prolonged infections, per the Investigator's judgment.
* History of human immunodeficiency virus (HIV) infection or positive HIV serology at screening.
* In the Investigator's opinion, any clinically significant laboratory results from the chemistry, hematology or urinalysis tests available in the medical history.
* Presence of skin comorbidities that may interfere with study assessments.
* History of malignancy, including mycosis fungoides, within 5 years before the screening visit, except completely treated in situ carcinoma of the cervix, completely treated and resolved non-metastatic squamous or basal cell carcinoma of the skin.
* Severe concomitant illness(es) that in the Investigator's judgment would adversely affect the patient's participation in the study. Any other medical or psychological condition that in the opinion of the Investigator may suggest a new and/or insufficiently understood disease, may present an unreasonable risk to the study patient because of his/her participation in this clinical trial, may make patient's participation unreliable, or may interfere with study assessments.

  20\. Pregnant or breastfeeding women, or women planning to become pregnant or breastfeed during the study.

Where this trial is running

Folsom, California and 3 other locations

• Physioseq USA - CA — Folsom, California, United States (Recruiting)
• University of Michigan — Ann Arbor, Michigan, United States (Not_yet_recruiting)
• University of Freiburg — Freiburg im Breisgau, Germany (Not_yet_recruiting)
• Lausanne University Hospital — Lausanne, Switzerland (Not_yet_recruiting)

Study contacts

• Principal investigator: Johann E. Gudjonsson, MD, PhD — University of Michigan
• Study coordinator: Diane Fiolek

Conditions Atopic Dermatitis