Improved quality of life in patients treated with lebrikizumab monotherapy is mediated by improvements in itch and sleep: results from two phase III trials in patients with moderate-to-severe atopic dermatitis

Pruritus is a hallmark symptom of atopic dermatitis (AD) and is known to worsen patients' health-related quality of life. Lebrikizumab is a high-affinity monoclonal antibody that binds interleukin-13, a key cytokine implicated in AD. This study includes data from two phase III randomized controlled trials that assessed the efficacy and safety of lebrikizumab in patients with moderate-to-severe AD, ADvocate1 (NCT04146363) and ADvocate2 (NCT04178967). We report a post hoc analysis to quantify the effect of lebrikizumab vs. placebo on the Dermatology Life Quality Index (DLQI) mediated indirectly through its effect on patient-reported outcomes, specifically itch and the interference of itch on sleep. Approximately two-thirds of the improvement at week 16 in DLQI experienced by patients treated with lebrikizumab vs. patients treated with placebo was mediated by improvements in itch and the interference of itch on sleep. Itch is a hallmark symptom of atopic dermatitis (AD) and is known to impact sleep and worsen patients' health-related quality of life (QoL). Lebrikizumab is a high-affinity monoclonal antibody that binds interleukin-13, a key cytokine implicated in AD, and has been shown to improve itch and QoL in clinical trials. In this mediation analysis, lebrikizumab was found to be effective in improving the QoL of patients with moderate-to-severe AD, primarily through the effect of lebrikizumab on the Pruritus Numeric Rating Scale and interference of itch on sleep.