1291 Tralokinumab improves signs, symptoms, and key biomarkers in patients of different racial subgroups with atopic dermatitis

Tralokinumab, an antibody that specifically neutralizes interleukin (IL)-13, is approved for treatment of adolescents (Europe/UK) and adults (multiple countries) with moderate-to-severe atopic dermatitis (AD). Differences in AD prevalence, clinical presentation, and pathophysiology have been reported in different ethnic/racial groups, yet clinical data for patients with skin of color are limited. We examined baseline biomarker expression and response to tralokinumab in patients by self-reported racial subgroup (Asian/Black/White) from the phase 3 ECZTRA 1 (NCT03131648) trial. Serum and skin samples collected at baseline and Week 16 were analyzed for expression of key biomarkers by immunoassay, and for AD gene expression and S. aureus abundance by qPCR. Baseline median EASI was significantly higher for Japanese Asian (37.4; N=127) compared to US Asian (25.2; N=33), Black (26.3; N=58), and White (27.2; N=561) patients (P<0.05). At baseline, serum levels of AD biomarkers, including IgE, eosinophils, IL-13, CCL17, and IL-22, were significantly higher in Japanese patients compared to other subgroups (P<0.05). US Asian patients had higher serum IL-17A and lower S. aureus abundance relative to other subgroups. In skin, gene expression of IL13RA1, IL4R, CCL2, and DPP4 was higher in Asian compared to White patients. Tralokinumab shifted biomarker expression, reduced S. aureus abundance, and improved signs/symptoms of AD across all racial subgroups over 16 weeks.