Letter to the Editor Regarding “Anchored Matching-Adjusted Indirect Comparison of the Long-Term Maintenance of Efficacy of Tralokinumab and Lebrikizumab in Patients with Moderate-to-Severe Atopic Dermatitis” - Summary - MDSpire
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Response to the Editor Concerning the “Indirect Comparison of Long-Term Efficacy Maintenance between Tralokinumab and Lebrikizumab in Patients with Moderate-to-Severe Atopic Dermatitis”
To address the limitations of the anchored matching-adjusted indirect comparison (MAIC) of tralokinumab and lebrikizumab in atopic dermatitis.
Approach:
Analysis of Patient Populations: The analysis focused on a subset of patients who achieved week-16 responses, highlighting differences in response rates between treatments.
Comparison of Mechanisms: Tralokinumab and lebrikizumab target IL-13 but differ in binding sites and pharmacokinetics, affecting their clinical efficacy.
Evaluation of Withdrawal Arms: The withdrawal arms of the trials were deemed not comparable due to different treatments received prior to withdrawal.
Key Findings:
Response rates at week 16 were 52% for lebrikizumab and 28% for tralokinumab.
Lebrikizumab has a significantly higher binding affinity for IL-13 and achieves steady-state concentrations faster than tralokinumab.
Post-treatment withdrawal, 56% of lebrikizumab responders maintained EASI 75 compared to 26% for tralokinumab.
Interpretation:
The differences in pharmacodynamics and patient selection raise concerns about the validity of the MAIC conclusions.
Limitations:
The analysis was based on a selective patient population, which may not represent the broader patient population.
The MAIC approach cannot account for unmeasured differences in treatment response between the cohorts.
Conclusion:
The findings suggest that lebrikizumab may offer superior long-term efficacy maintenance compared to tralokinumab, but the analysis has significant limitations.
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