Lebrikizumab

How it works

It is a humanised monoclonal antibody that binds interleukin-13 with high affinity, blocking IL-13 signalling, a key driver of type 2 inflammation in atopic dermatitis.

Prescribing in practice

• Conjunctivitis is a recognised class-related adverse effect; advise patients to report new or worsening eye symptoms and assess if persistent.
• Live vaccines should be avoided during treatment, and patients should be screened and treated for active helminth or other relevant infections before starting.
• Given by subcutaneous injection with an initial loading phase followed by maintenance dosing; it may be used with or without topical corticosteroids.

Monitoring

Monitor clinical response and for ocular adverse effects such as conjunctivitis and hypersensitivity reactions.

Counselling the patient

• Report red, sore or itchy eyes, as conjunctivitis can occur with this treatment.
• Tell your healthcare team before having any vaccinations, particularly live vaccines.
• Continue using your emollients and any topical treatments as advised.

Evidence & guidelines

Lebrikizumab's efficacy in moderate-to-severe atopic dermatitis was demonstrated in the ADvocate and ADhere phase 3 trials, and it is appraised by NICE for this indication.