ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
IL-13 Inhibitor — Atopic Eczema Pregnancy: Avoid — limited data; use effective contraception during treatment

Tralokinumab

Brand names: Adtralza

Adult dose

Dose: 600 mg SC (four 150 mg injections) at week 0, then 300 mg every 2 weeks for 16 weeks, then 300 mg every 4 weeks (if controlled at week 16)
Route: SC injection
Frequency: Every 2 weeks (induction/maintenance) or every 4 weeks (if well-controlled)
Max: 300 mg every 2 weeks
IL-13 specific inhibitor for moderate-to-severe atopic eczema in adults. Alternative to dupilumab when IL-4/13 dual blockade is not tolerated. ECZTRA-3 trial: combination with topical corticosteroids showed 58% IGA 0/1 response at week 16.

Paediatric dose

Dose: Seek specialist opinion mg/kg
Route: SC
Frequency: Every 2 weeks
Max: Not established in children
Not currently licensed in children — clinical trials ongoing; specialist paediatric dermatology only

Dose adjustments

Renal

No dose adjustment required

Hepatic

No dose adjustment required

Paediatric weight-based calculator

Not currently licensed in children — clinical trials ongoing; specialist paediatric dermatology only

Clinical pearls

  • Selective IL-13 blockade (vs dupilumab's dual IL-4/13 blockade) — different target, different safety profile; lower conjunctivitis rate than dupilumab (~5% vs 10–20%)
  • ECZTRA-1 and ECZTRA-2 trials: tralokinumab monotherapy — 25–26% IGA 0/1 at week 16; combination with TCS (ECZTRA-3): 38% IGA 0/1
  • NICE TA869 (2023): tralokinumab recommended for moderate-to-severe atopic eczema in adults when dupilumab is not suitable or has failed
  • Responders at week 16 who achieve IGA 0/1 can switch to 4-weekly dosing — reduces injection frequency and cost
  • IL-13 is the primary driver of Th2 inflammation in atopic eczema — itch, barrier dysfunction, IgE production; IL-4 additionally drives IgE class switching
  • Conjunctivitis rate significantly lower than dupilumab — may be preferred in patients who developed conjunctivitis on dupilumab

Contraindications

  • Hypersensitivity to tralokinumab
  • Active helminth infection (treat before initiating)

Side effects

  • Conjunctivitis (less common than with dupilumab)
  • Injection site reactions
  • Upper respiratory tract infections
  • Herpes simplex reactivation

Interactions

  • Live vaccines — avoid during treatment

Monitoring

  • EASI score at 16 weeks (NICE response criterion)
  • IGA score
  • Conjunctivitis symptoms
  • Infection surveillance

Reference: BNFc; BNF 90; ECZTRA-3 Trial (Wollenberg et al. NEJM 2021); NICE TA869; SPC Adtralza. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Drugs
Pathways