Lebrikizumab Delivers Near-Complete Skin Clearance Without Topical Corticosteroids at 4 Years

For patients with moderate to severe atopic dermatitis, the question clinicians hear most often isn't whether a treatment works at week 16 — it's whether it keeps working. New interim data from the ADlong phase 3b extension study, presented this week at the American Academy of Dermatology (AAD) Annual Meeting in Denver, offer some of the most compelling long-term evidence to date for lebrikizumab, with efficacy outcomes holding — and in some measures strengthening — at up to 4 years of continuous treatment.¹

The results, reported as observed at week 48 of the ADlong study (representing up to 4 cumulative years of lebrikizumab exposure across parent trials), showed that 94% of patients achieved EASI-75, the threshold widely regarded as clinically meaningful skin improvement. Three-quarters reached EASI-90, reflecting near-complete clearance, and 68% attained IGA 0 or 1 — essentially clear or almost clear skin. Itch relief, often harder to sustain and among the most debilitating aspects of the disease for patients, was achieved in 78%, defined as a Pruritus NRS score of 4 or below.

What makes these figures notable isn't just their magnitude, but the treatment context in which they were achieved. The majority of patients, 80%, reached these endpoints without topical corticosteroids, and 80% were on monthly maintenance dosing rather than the more frequent every-2-week schedule. Most (77%) were on lebrikizumab monotherapy. In other words, this wasn't a population being propped up by adjunctive therapies; it reflects what sustained biologics management can look like in practice.

Building on an Established Trajectory

ADlong (NCT05916365) is an open-label extension enrolling adult and adolescent patients (ages 12–17, ≥40 kg) from Germany and Poland who completed the 100-week ADjoin study, which itself followed responders from the ADvocate 1 and 2, ADore, and ADhere trials. The 174 patients in this analysis represent a population with already-established response to lebrikizumab, and the data speak to durability rather than induction — a clinically distinct and arguably more important question for long-term management decisions.

These findings extend a narrative that has been building over several years of clinical investigation. Previously published data demonstrated that continued treatment for 2 years allowed 41% of a responder population to achieve complete skin clearance and itch resolution — a bar that would have seemed ambitious at trial initiation. The 4-year interim data suggest the ceiling for response in committed, continuous therapy may be higher still.

A Safety Profile That Continues to Hold

Among the concerns that shape prescribing decisions for any biologic, long-term safety tolerability carries particular weight.² In the ADlong first-year interim analysis, no new safety signals emerged. The reported treatment-related adverse events — nasopharyngitis, upper respiratory tract infection, and conjunctivitis — are consistent with the established profile from earlier lebrikizumab trials. Most events were mild or moderate and did not result to discontinuation.

For clinicians who have been cautious about committing patients to indefinite biologic therapy without reassurance that the risk-benefit calculus remains favorable over time, this data point matters.

The Mechanistic Rationale Holds Up

Lebrikizumab's mechanism — selective, high-affinity targeting of IL-13 to block downstream signaling — positions it within a class of therapies designed to interrupt a central driver of type 2 inflammatory disease without broadly suppressing immune function. The ability to maintain these outcomes on a once-monthly regimen, without adjunctive corticosteroids, arguably reflects the targeted nature of that approach.

The ADlong study remains ongoing, with an additional year of treatment to follow.

References

1. Lebrikizumab delivered long-term disease control for up to four years in patients with moderate-to-severe atopic dermatitis. News release. Almirall. Published March 27, 2026. Accessed March 27, 2026. https://www.almirall.com/newsroom/news/lebrikizumab-delivered-long-term-disease-control-for-up-to-four-years-in-patients-with-moderate-to-severe-atopic-dermatitis
2. An M, Lio P. Reaching for the stars in atopic dermatitis: efficacy, safety, tolerability, accessibility, and remission/remittive effects (ESTAR). J Clin Aesthet Dermatol. 2025;18(11):16-20.