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- Title
Safety and Efficacy of Tralokinumab in Older Adults With Moderate-to-Severe Atopic Dermatitis: A Secondary Analysis.
- Authors
Merola, Joseph F.; Butler, Daniel C.; Mark, Thomas; Schneider, Shannon; Kim, Yestle; Abuabara, Katrina
- Abstract
Key Points: Question: In an older adult population (≥65 years) that has polypharmacy and increased safety risks, what are the safety and efficacy outcomes following treatment with tralokinumab for moderate-to-severe atopic dermatitis? Findings: In this secondary analysis of 3 randomized clinical trials of 75 older adults with moderate-to-severe atopic dermatitis, treatment with tralokinumab was well tolerated and effective. Meaning: The results of this secondary analysis suggest that tralokinumab has a safe, tolerable, and effective profile for use in older patients with moderate-to-severe atopic dermatitis who typically face unique treatment challenges. Importance: Older adults with atopic dermatitis (AD) face unique treatment challenges, including comorbidities, polypharmacy, and a higher risk for infections (eg, herpes zoster). Furthermore, limited data are available from clinical trials for treatments in this population. In phase 3 studies, tralokinumab showed superior efficacy in moderate-to-severe AD vs placebo, but results were not stratified by age group. Objective: To evaluate the safety and efficacy of tralokinumab in older (≥65 years) patients with moderate-to-severe AD. Design, Setting, and Participants: A post hoc analysis for adults 65 years or older was conducted from a subset of patients in the US, Canada, Europe, and Asia in 3 randomized, placebo-controlled, phase 3 trials (ECZTRA 1 and 2 [monotherapy] and ECZTRA 3 [tralokinumab + topical corticosteroids as needed]). The post hoc data were analyzed in 2022. Main Outcomes and Measures: Pooled data from up to 16 weeks of treatment from ECZTRA 1, 2, and 3 were used to assess safety. Statistical analyses followed prespecifications of primary end points. Separate efficacy analyses were conducted in these trials respectively at 16 weeks. Results: A total of 75 older adults (42 women [56%]) treated with tralokinumab from the ECZTRA 1, 2, and 3 trials were included in this post hoc analysis. Similar proportions of patients reported adverse events (AEs) with tralokinumab and placebo (44 [58%]). Three patients (4%) in the tralokinumab arm and 3 (10.3%) in the placebo arm experienced severe AEs, and 4 (5.3%) and 2 (6.9%), respectively, had AEs leading to discontinuation. More patients achieved 75% or greater improvement in Eczema Area and Severity Index scores with tralokinumab than placebo (33.9% vs 4.8%; P <.001) in ECZTRA 1 and 2. Similar trends, although not statistically significant, were seen in ECZTRA 3. Safety and efficacy outcomes in this population were similar compared with the younger patient cohorts. The small sample size limited generalizations from this analysis. Conclusion and Relevance: The results of this post hoc analysis suggest that tralokinumab is well tolerated and efficacious in patients 65 years or older with moderate-to-severe AD. This secondary analysis of 3 randomized clinical trials evaluates the safety and efficacy of tralokinumab in older patients with moderate-to-severe atopic dermatitis.
- Publication
JAMA Dermatology, 2023, Vol 159, Issue 10, p1119
- ISSN
2168-6068
- Publication type
Article
- DOI
10.1001/jamadermatol.2023.2626