P132 Safety and effectiveness of tralokinumab treatment in adults with atopic dermatitis who previously discontinued dupilumab due to the adverse event conjunctivitis: 12-months real-world data from the TRACE study

Abstract

Emerging evidence suggests that tralokinumab is an effective and well-tolerated option for dupilumab-experienced patients with atopic dermatitis (AD). This analysis evaluates the real-world safety and effectiveness of tralokinumab in patients with AD who had discontinued dupilumab due to the adverse event (AE) conjunctivitis prior to initiating tralokinumab. TRACE is a prospective, noninterventional, international, single-cohort study of adults with AD prescribed tralokinumab according to national approved label at the treating physician’s discretion. Outcomes measured included AEs and Eczema Area and Severity Index (EASI). Of the 182 patients previously treated with dupilumab, 39 (21.4%) had discontinued dupilumab due to conjunctivitis. Among these, 17 (44%) reported AEs while on tralokinumab. Conjunctivitis was the only AE by MedDRA preferred term reported by more than one patient, occurring in 10 patients (26%). Seven of these cases (18%) were assessed by the physician as possibly related to tralokinumab. Most (six of seven, 87%) had mild or moderate conjunctivitis, while one patient (15%) experienced severe symptoms. Importantly, none of these patients discontinued tralokinumab due to conjunctivitis. Rapid and sustained improvements in disease severity were observed with up to 12 months of tralokinumab treatment in patients who had discontinued dupilumab due to conjunctivitis, which is consistent with the larger subgroup of dupilumab-experienced patients. The proportion with EASI ≤ 7 (no or mild disease) increased from 44% (16 of 36) at baseline to 81% (13 of 16) at 12 months of tralokinumab treatment in those who had previously discontinued dupilumab due to conjunctivitis, and from 26% (33 of 127) at baseline to 84% (43 of 51) at 12 months in overall dupilumab-experienced patients. Among patients who discontinued dupilumab due to conjunctivitis, > 80% did not develop conjunctivitis related to tralokinumab therapy in a real-world setting. Conjunctivitis on tralokinumab was primarily mild to moderate and did not lead to discontinuation. Overall, tralokinumab treatment was associated with continued improvements in AD severity over 12 months, even in this ­dupilumab-experienced population.