Atopic Dermatitis Patients Treated with Tralokinumab See No Greater COVID-19 Risk

A new study found that patients with severe atopic dermatitis (AD) who are treated with tralokinumab do not face a greater COVID-19 infection risk, nor does it compromise the COVID-19 vaccines’ efficacy.¹

Tralokinumab, an IgG4 monoclonal antibody that neutralizes interleukin (IL-13), has demonstrated safety and efficacy in clinical trials investigating the drug as a potential treatment for adults with moderate to severe AD. Meanwhile, concerns grew during the COVID-19 pandemic that immunomodulatory drugs could increase susceptibility or severity of diseases or affect the efficacy of the SARS-CoV-2 vaccination.

Study investigators evaluated data from 1442 AD patients enrolled in the ECZTEND study, a long-term, open-label extension trial. Participants were given 300 mg of tralokinumab subcutaneously every 2 weeks and optional topical corticosteroids after a 600-mg loading dose. They also reported COVID-19 as an adverse event during routine clinic visits.

The ECZTEND trial enrolled 77 patients diagnosed with COVID-19 and 76 unvaccinated when infected. Many patients had established or probable risk factors for severe illness according to the Centers for Disease Control and Prevention classification: 4 (5%) were 60 years or older, 10 (13%) had hypertension, 42 (55%) had asthma, and 51 (66%) had a body mass index of 25 or greater (overweight or obesity).

The study’s authors found severity to be mild (n=52 [68%]) or moderate (n=23 [30%]). Two patients had several risk factors who reported more severe symptoms. Tralokinumab was not reported to play a role in their symptoms.

There were 2 reported cases that investigators said were potentially associated with tralokinumab therapy. Both of those COVID-19 patients were under 30-years-old and neither case lasted more than 22 days. The authors found no new safety signals or evidence for any reduced effectiveness of the SARS-CoV-2 vaccines, parallel to the tralokinumab therapy.

AD affects more than 16.5 million adults in the United States and is the most common type of eczema.² As a chronic condition, it can flare up at any time and even overlap with other types of eczema.

The authors noted limitations in this study. First, asymptomatic, or mild COVID-19 may not have been recognized. Second, the series lacked a comparison group of COVID-19 patients with AD not treated with tralokinumab. This research letter, “Outcomes of COVID-19 and Vaccination in Patients with Moderate to Severe Atopic Dermatitis Treated with Tralokinumab,” was published online in JAMA Dermatology.

References

1. Blauvelt A, Pink A, Worm M, et al. Outcomes of COVID-19 and Vaccination in Patients with Moderate to Severe Atopic Dermatitis Treated with Tralokinumab. JAMA Dermatol. Published online October 12, 2022. doi:10.1001/jamadermatol.2022.3488
2. What is atopic dermatitis and how can I tell if I have it? National Eczema Association. October 2, 2022. Accessed October 12, 2022. https://nationaleczema.org/eczema/types-of-eczema/atopic-dermatitis/