Tralokinumab

How it works

It specifically binds the cytokine interleukin-13 (IL-13), preventing it from engaging its receptors and thereby dampening the type 2 inflammatory signalling that drives atopic dermatitis.

Prescribing in practice

• Live vaccines should be avoided during treatment because of the immunomodulatory effect; ensure age-appropriate immunisations are up to date beforehand.
• Conjunctivitis and keratitis are recognised adverse effects; advise patients to report new or worsening eye symptoms.
• Reserve for moderate-to-severe disease in line with NICE criteria, and review response after an adequate trial as set out in current prescribing references.

Monitoring

Assess clinical response (such as disease severity scores) periodically and monitor for ocular adverse effects and signs of hypersensitivity.

Counselling the patient

• This is a long-term injection given under the skin; you may be taught to self-inject at home.
• Tell your clinician promptly if you develop sore, red or watery eyes.
• Continue your usual emollients and any prescribed topical treatments unless advised otherwise.

Evidence & guidelines

NICE has issued technology appraisal guidance supporting tralokinumab for moderate-to-severe atopic dermatitis where conventional systemic therapy is inadequate or unsuitable.