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Peer-reviewedCC BY-NC 4.0Dermatology and Therapy

Tralokinumab Versus Dupilumab for the Treatment of Atopic Dermatitis with Moderate-to-Severe Hand Involvement: A Matching-Adjusted Indirect Comparison

  • April Armstrong1
  • Leon Kircik2,3
  • Andrei Metelitsa4,5
  • Richard B. Warren6
  • Adrian Rodriguez7
  • Sebastian Volc8
  • Naiem Issa9,10,11
  • Raj Chovatiya12,13
  • Rie von Eyben14
  • Teodora Festini14
  • Pierre Johansen14
  • Benjamin Ehst15
15 affiliations
  1. 1Department of Dermatology, University of California Los Angeles, Los Angeles, CA USA
  2. 2Icahn School of Medicine at Mount Sinai, New York, NY USA
  3. 3Indiana University School of Medicine, Indianapolis, IN USA
  4. 4Division of Dermatology, University of Calgary, Calgary, AB Canada
  5. 5Beacon Dermatology, Calgary, AB Canada
  6. 6Dermatology Centre, Northern Care Alliance NHS Foundation Trust and Division of Musculoskeletal and Dermatological Sciences, Manchester NIHR Biomedical Research Centre, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
  7. 7Nashville Skin Comprehensive Dermatology Center, Advanced Research Experts, and Frist College of Medicine, Belmont University, Nashville, TN USA
  8. 8Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
  9. 9Forefront Dermatology, Vienna, VA USA
  10. 10University of Miami School of Medicine, Miami, FL USA
  11. 11George Washington University School of Medicine and Health Sciences, Washington, DC USA
  12. 12Rosalind Franklin University of Medicine and Science Chicago Medical School, Chicago, IL USA
  13. 13Center for Medical Dermatology + Immunology Research, North Chicago, IL USA
  14. 14LEO Pharma A/S, Ballerup, Denmark
  15. 15Oregon Medical Research Center, Portland, OR USA
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Abstract

Introduction: Both tralokinumab and dupilumab have shown efficacy in atopic dermatitis (AD) with moderate-to-severe hand involvement in double-blind phase 3 trials. As there are no head-to-head studies of tralokinumab and dupilumab, an anchored matching-adjusted indirect comparison (MAIC) was conducted.

Methods: In the ADHAND trial, adults with AD with moderate-to-severe hand involvement were randomised to tralokinumab 300 mg or placebo every 2 weeks for 16 weeks. In the LIBERTY-AD-HAFT trial, adults and adolescents (≥ 12 years) with moderate-to-severe AD with hand and/or foot involvement were randomised to dupilumab 300 mg or placebo every 2 weeks for 16 weeks. An anchored MAIC was conducted using individual patient data from ADHAND weighted to match aggregate data for age, sex, race, and baseline Hand Eczema Severity Index (HECSI) score from LIBERTY-AD-HAFT, with placebo as the common anchor. Endpoints compared at week 16 were proportions of patients with Investigator’s Global Assessment scores of 0/1, HECSI-75 and HECSI-90, and percent reductions in HECSI and the Routine Activity Impairment domain of the Work Productivity and Activity Index. Reductions in itch and pain and proportions of patients with ≥ 4-point itch improvement were also compared.

Results: LIBERTY-AD-HAFT included 133 patients (dupilumab, n = 67, placebo, n = 66) while ADHAND included 235 patients (tralokinumab, n = 156; placebo, n = 79). The effective sample size after matching was 99 (tralokinumab, n = 76, placebo, n = 23). Anchor-adjusted relative treatment differences significantly favoured tralokinumab compared with dupilumab for the proportions of patients achieving HECSI-90 (17.5% [95% CI 0.8, 34.2]; p = 0.040) and decrease in percent routine activity impairment (16.0% [95% CI 4.8, 27.1]; p = 0.005). Relative differences for other endpoints favoured tralokinumab over dupilumab but were not significantly different between treatments.

Conclusion: In this anchored MAIC, tralokinumab was associated with a higher placebo-adjusted response than dupilumab, with a higher proportion achieving HECSI-90, and a significantly greater improvement in ability to perform regular daily activities versus dupilumab. Other endpoints were numerically in favour of tralokinumab.

Graphical abstract and video abstract available for this article.

Clinical Trial Registration: NCT05958407, NCT04417894.

Video Abstract (MP4 112997 KB)

Graphical Abstract:

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s13555-026-01922-8.

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Cite

BibTeXRIS
BibTeX
@article{armstrong2026tralokinumab,
  title = {{Tralokinumab Versus Dupilumab for the Treatment of Atopic Dermatitis with Moderate-to-Severe Hand Involvement: A Matching-Adjusted Indirect Comparison}},
  author = {April Armstrong and Leon Kircik and Andrei Metelitsa and Richard B. Warren and Adrian Rodriguez and Sebastian Volc and Naiem Issa and Raj Chovatiya and Rie von Eyben and Teodora Festini and Pierre Johansen and Benjamin Ehst},
  journal = {Dermatology and Therapy},
  year = {2026},
  month = oct,
  doi = {10.1007/s13555-026-01922-8},
  url = {https://doi.org/10.1007/s13555-026-01922-8},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Tralokinumab Versus Dupilumab for the Treatment of Atopic Dermatitis with Moderate-to-Severe Hand Involvement: A Matching-Adjusted Indirect Comparison
AU  - April Armstrong
AU  - Leon Kircik
AU  - Andrei Metelitsa
AU  - Richard B. Warren
AU  - Adrian Rodriguez
AU  - Sebastian Volc
AU  - Naiem Issa
AU  - Raj Chovatiya
AU  - Rie von Eyben
AU  - Teodora Festini
AU  - Pierre Johansen
AU  - Benjamin Ehst
PY  - 2026
DA  - 2026/10/02
JO  - Dermatology and Therapy
DO  - 10.1007/s13555-026-01922-8
UR  - https://doi.org/10.1007/s13555-026-01922-8
AB  - Introduction: Both tralokinumab and dupilumab have shown efficacy in atopic dermatitis (AD) with moderate-to-severe hand involvement in double-blind phase 3 trials. As there are no head-to-head studies of tralokinumab and dupilumab, an anchored matching-adjusted indirect comparison (MAIC) was conducted.  Methods: In the ADHAND trial, adults with AD with moderate-to-severe hand involvement were randomised to tralokinumab 300 mg or placebo every 2 weeks for 16 weeks. In the LIBERTY-AD-HAFT trial, adults and adolescents (≥ 12 years) with moderate-to-severe AD with hand and/or foot involvement were randomised to dupilumab 300 mg or placebo every 2 weeks for 16 weeks. An anchored MAIC was conducted using individual patient data from ADHAND weighted to match aggregate data for age, sex, race, and baseline Hand Eczema Severity Index (HECSI) score from LIBERTY-AD-HAFT, with placebo as the common anchor. Endpoints compared at week 16 were proportions of patients with Investigator’s Global Assessment scores of 0/1, HECSI-75 and HECSI-90, and percent reductions in HECSI and the Routine Activity Impairment domain of the Work Productivity and Activity Index. Reductions in itch and pain and proportions of patients with ≥ 4-point itch improvement were also compared.  Results: LIBERTY-AD-HAFT included 133 patients (dupilumab, n = 67, placebo, n = 66) while ADHAND included 235 patients (tralokinumab, n = 156; placebo, n = 79). The effective sample size after matching was 99 (tralokinumab, n = 76, placebo, n = 23). Anchor-adjusted relative treatment differences significantly favoured tralokinumab compared with dupilumab for the proportions of patients achieving HECSI-90 (17.5% [95% CI 0.8, 34.2]; p = 0.040) and decrease in percent routine activity impairment (16.0% [95% CI 4.8, 27.1]; p = 0.005). Relative differences for other endpoints favoured tralokinumab over dupilumab but were not significantly different between treatments.  Conclusion: In this anchored MAIC, tralokinumab was associated with a higher placebo-adjusted response than dupilumab, with a higher proportion achieving HECSI-90, and a significantly greater improvement in ability to perform regular daily activities versus dupilumab. Other endpoints were numerically in favour of tralokinumab.  Graphical abstract and video abstract available for this article.  Clinical Trial Registration: NCT05958407, NCT04417894.  Video Abstract (MP4 112997 KB)  Graphical Abstract:  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s13555-026-01922-8.
SN  - 2193-8210
SN  - 2190-9172
ER  -