AUTHOR=Bashrahil Bader , Alzahrani Ziyad , Samarkandy Sahal , Aman Abdullah , Jfri Abdulhadi 

TITLE=The efficacy and safety of lebrikizumab monotherapy for the management of moderate-to-severe atopic dermatitis: A systematic review and meta-analysis

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.1091271

DOI=10.3389/fmed.2022.1091271

ISSN=2296-858X

ABSTRACT=Background: Atopic dermatitis (AD) is a chronically relapsing disease. Few biologics are approved for moderate-to-severe AD, and novel interventions are emerging. We aimed to evaluate the safety and efficacy of lebrikizumab, an IL-13 immunomodulator, as a monotherapy versus placebo in treating moderate-to-severe AD.
Methods: Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, and clinical trials.gov registry (CT.gov) databases were systematically searched. We evaluated lebrikizumab versus placebo and measured efficacy using Eczema Area and Severity Index (EASI), Body Surface Area (BSA), and Investigator’s Global Assessment (IGA) change from baseline to week 16. Safety was evaluated by incidence of serious adverse events (SAEs), nonserious adverse events (NSAEs), and mortality. The risk of bias was investigated using the Revised Cochrane risk of bias tool.
Results: Three RCTs (n=1149) included 543 (47.25%) males vs. 606 (52.75%). Meta-analysis showed statistically significant improvement in EASI, IGA, and BSA. EASI75 at week 16 for all regimens was (RR= 2.62, 95% CI [2.06, 3.34], P<0.00001) with the first regimen (500 mg loading dose then 200 mg every 2 weeks) showing the most significant improvement (RR= 3.02, 95% CI [2.39, 3.82], P<0.00001). The pooled analysis of safety outcomes concluded that lebrikizumab did not correlate significantly to the incidence of SAEs, NSAEs, and mortality.
Conclusion: Overall, lebrikizumab showed a significant improvement in all efficacy outcomes. Additionally, it did not contribute to any significant incidence of SAEs, NSAEs, or mortality. The risk of bias in included RCTs was minor except in the randomization domain. GRADE assessment of the outcomes ranged from low to high, but predominantly high certainty of evidence.