Clinical and Laboratory Indexes for Predicting Early and Late Responders to Lebrikizumab in Atopic Dermatitis: A Prospective Cohort Observational Study

Background: An anti-interleukin-13 antibody lebrikizumab is effective for atopic dermatitis (AD). However, predictive factors for responders to lebrikizumab are unknown in real-world practice. Objective: To identify predictive factors for early and late responders to lebrikizumab treatment for AD. Methods: A prospective study was conducted with 112 Japanese patients with AD who received lebrikizumab between May 2024 and February 2025. Early responders were defined as patients who achieved investigator's global assessment (IGA) 0/1 at week 12, and late responders were defined as those who did not achieve IGA 0/1 at week 12 but achieved IGA 0/1 at week 24. We compared patients' background factors and baseline clinical or laboratory indexes between responders and poor responders. Results: Early responders showed lower baseline eczema area and severity index (EASI), thymus and activation-regulated chemokine (TARC), lactate dehydrogenase (LDH), and platelet-to-lymphocyte ratio (PLR) while late responders showed lower baseline immunoglobulin E (IgE), eosinophil-to-lymphocyte ratio (ELR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), PLR, systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) compared with respective poor responders. Conclusions: Patients with AD with lower baseline EASI, TARC, LDH, and PLR may predict early responses, while those with lower baseline IgE, ELR, NLR, MLR, PLR, SII, and SIRI may predict late responses to lebrikizumab.