Effectiveness of Tralokinumab for Moderate-to-Severe Atopic Dermatitis Involving the Head-and-Neck Area: A Multicenter Retrospective Cohort Study

Background: Atopic dermatitis (AD) affecting the head and neck (H&N) area poses a clinical challenge due to the unique anatomical and physiological features of this region. Despite its well-documented impact on quality of life (QoL), evidence on the effectiveness of tralokinumab in treating AD specifically in the H&N area remains limited. Objective: To assess the clinical outcomes of tralokinumab in AD patients with H&N involvement, informing clinical decision-making and improving patient care. Methods: A multicenter, retrospective cohort study across 5 Italian tertiary referral hospitals. Patients were stratified by H&N involvement, and treatment outcomes were assessed using the Eczema Area and Severity Index (EASI), EASI H&N, Investigator Global Assessment (IGA), Numerical Rating Scale (NRS) pruritus, NRS sleep, Dermatology Life Quality Index, Patient-Oriented Eczema Measure, and Atopic Dermatitis Control Tool. Results: Among 211 patients, 145 (68.7%) had H&N involvement. A significant reduction in EASI H&N scores from baseline to weeks 12-16 (38.1%) and week 24 (54.5%) was achieved. Significant improvements in IGA, NRS pruritus, and NRS sleep, and QoL measures emerged within 12-16 weeks and persisted at 24 weeks. Compared with patients without H&N involvement, those with H&N involvement exhibited a stronger atopic background and showed no evidence of reduced drug survival. Adverse events, mainly conjunctivitis, were comparable between groups. Conclusions: Tralokinumab is effective and well-tolerated in managing moderate-to-severe AD involving the H&N area, even in biologic-experienced patients. These findings support its use as a targeted therapy addressing both clinical and psychosocial burdens of H&N AD.