Lebrikizumab Improves Hand and Foot Atopic Dermatitis in Phase 3b ADtouch Trial

Lebrikizumab-lbkz (Ebglyss) demonstrated significant and rapid improvements in skin clearance, itch, pain, and patient-reported outcomes among adults and adolescents with moderate-to-severe atopic hand and foot dermatitis, according to late-breaking phase 3b data presented at the 2026 European Academy of Dermatology and Venereology (EADV) Congress in Vienna, Austria.¹

The 16-week ADtouch trial met its primary and secondary endpoints, with 53% of patients receiving lebrikizumab achieving clear or almost clear skin of the hands and feet at week 16 compared with 27% receiving placebo.

Improvements in skin clearance were observed as early as week 4, when 17% of patients receiving lebrikizumab achieved a Hand and Foot Investigator Global Assessment (HF-IGA) score of 0 or 1 with at least a 2-point improvement, compared with 6% of patients receiving placebo.

Addressing a High-Burden Manifestation of AD

Although hand and foot involvement may affect a relatively limited body surface area, its effect on patients can be substantial. Hand involvement occurs in up to 60% of patients with atopic dermatitis (AD), while approximately 30% also experience foot involvement.

Patients enrolled in ADtouch had moderate-to-severe involvement of the hands and feet despite generally limited AD across the remainder of the body. At baseline, patients experienced severe itch, moderate pain, and substantial impairment in quality of life.

The phase 3b, randomized, double-blind, placebo-controlled trial included 221 adults and adolescents aged 12 years and older with moderate-to-severe atopic hand and foot dermatitis and an inadequate response to topical therapies. Participants were randomized 1:1 to receive lebrikizumab 250 mg or placebo every 2 weeks following an initial loading dose. All participants used moisturizer on the hands and feet throughout the study.

Rapid Improvements in Itch and Pain

Beyond physician-assessed skin clearance, lebrikizumab produced improvements across patient-reported measures of itch and pain.

At week 16, 57% of patients treated with lebrikizumab achieved at least a 4-point improvement in Hand and Foot Peak Pruritus Numeric Rating Scale (NRS) scores compared with 19% receiving placebo. Improvements in itch emerged early, with 16% of the lebrikizumab group achieving this threshold by week 2 compared with 1% of the placebo group.

Pain responses were similarly notable. At week 16, 59% of patients receiving lebrikizumab achieved at least a 4-point improvement in Hand and Foot Peak Pain NRS scores compared with 19% receiving placebo.

“For people with hand and foot atopic dermatitis, a relatively small area of affected skin can have an outsized impact on daily life,” said Shawn G. Kwatra, MD, Joseph W. Burnett Endowed Professor and Chair in Dermatology and Chief of Service, Dermatology, at the University of Maryland School of Medicine and University of Maryland Medical Center.

Kwatra noted that the findings highlight the importance of assessing disease burden beyond visible skin involvement, particularly outcomes such as pain and itch that can substantially affect patients’ everyday activities.

Patient Satisfaction and Quality of Life

ADtouch also included patient satisfaction data assessing how patients perceived improvement in their hand disease.

Among patients who were dissatisfied with their hand dermatitis clearance at baseline, 77% of those receiving lebrikizumab reported being satisfied or very satisfied with their hand clearance at week 16 compared with 40% receiving placebo.

Patients receiving lebrikizumab also experienced a 57% mean improvement in the impact of hand disease on quality of life, as measured by the Quality of Life in Hand Eczema Questionnaire, compared with a 28% improvement in the placebo group.

The need for rescue medication was lower with active treatment as well. Through week 16, 6% of patients receiving lebrikizumab required topical or systemic rescue medication compared with 18% receiving placebo.

Safety Findings

The safety profile observed in ADtouch was consistent with previous studies of lebrikizumab, with no new safety signals identified.

Treatment-emergent adverse events occurred in 41.8% of patients receiving lebrikizumab and 39.6% receiving placebo, with all events reported as mild or moderate in severity. The most common adverse events reported with lebrikizumab were nasopharyngitis and upper respiratory tract infection.

Adverse events leading to treatment discontinuation occurred in 0.9% of patients receiving lebrikizumab compared with 2.7% receiving placebo.

Potential Implications for Localized AD

Lebrikizumab is a monoclonal antibody that selectively targets and neutralizes interleukin-13 (IL-13), a cytokine involved in the type 2 inflammatory pathway underlying AD.

The drug is currently approved in the US for adults and children aged 12 years and older weighing at least 40 kg with moderate-to-severe AD that is inadequately controlled with topical prescription therapies or when those therapies are not advisable.

The ADtouch findings may help further characterize the role of systemic treatment for patients whose disease is concentrated in smaller but functionally important areas such as the hands and feet.

Lilly reported that the ADtouch data have been submitted to the US Food and Drug Administration and that the company plans submissions to select global regulatory authorities for a potential label update incorporating data for localized AD with moderate-to-severe hand and foot involvement.

References

1. Silverberg K, Simpson E, Laquer V, et al. Lebrikizumab is effective in patients with atopic hand and foot dermatitis: 16-week results from the randomized, double-blind, placebo-controlled ADtouch trial. Presented at: European Academy of Dermatology and Venereology (EADV) Congress; September 29-October 3, 2026; Vienna, Austria.
2. Bieber T. Interleukin-13: Targeting an underestimated cytokine in atopic dermatitis. Allergy. 2020;75(1):54-62. doi:10.1111/all.13954
3. Tsoi LC, Rodriguez E, Degenhardt F, et al. Atopic dermatitis is an IL-13-dominant disease with greater molecular heterogeneity compared to psoriasis. J Invest Dermatol. 2019;139(7):1480-1489. doi:10.1016/j.jid.2018.12.018
4. EBGLYSS (lebrikizumab-lbkz). Prescribing information. Lilly USA, LLC.