Lebrikizumab

How it works

It binds interleukin-13 and prevents its signalling, dampening the type 2 inflammation responsible for the skin barrier dysfunction, itch and inflammation of atopic dermatitis.

Prescribing in practice

• Conjunctivitis is a recognised class-related adverse effect; advise patients to report new or persistent eye symptoms.
• Assess for active infection before starting and avoid live vaccines during treatment.
• It may be used with or without topical corticosteroids and is given by subcutaneous injection.

Monitoring

Monitoring is predominantly clinical, assessing eczema severity and itch response and reviewing for conjunctivitis or other ocular symptoms.

Counselling the patient

• Report red, sore or gritty eyes, as conjunctivitis can occur with this medicine.
• You may continue your usual emollients and may still need topical treatments for flares.
• Improvement in itch and skin appearance builds over several weeks of regular dosing.

Evidence & guidelines

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