Routine blood biomarkers associated with clinical response to tralokinumab in patients with atopic dermatitis: a 48-week real-world study in Japan.

Abstract

Tralokinumab is effective for atopic dermatitis (AD), however, biomarkers reflecting its therapeutic effects have not been fully established. To evaluate whether blood biomarkers are associated with clinical response to tralokinumab during 48 weeks of treatment for AD. We conducted a prospective two-centre observational study of 203 patients with moderate-to-severe AD treated with tralokinumab between October 2023 and October 2025. Eczema Area and Severity Index (EASI) and Peak Pruritus-Numerical Rating Scale (PP-NRS) were evaluated at weeks 0, 4, 12, 16, 24, 36, and 48. Serum immunoglobulin E (IgE), thymus and activation-regulated chemokine (TARC), lactate dehydrogenase (LDH), and total eosinophil count were evaluated simultaneously. Percent reduction of TARC correlated with decreased EASI and PP-NRS at weeks 4 and 12. Percent reduction of IgE correlated with decreased EASI at weeks 4 and 12 and decreased PP-NRS at week 4. Percent reduction of LDH correlated with decreased EASI at weeks 4, 12, and 24, whereas a correlation with PP-NRS was significant only at week 4. The level of TARC may reflect the early therapeutic effects of tralokinumab on both clinical signs and pruritus in patients with AD. IgE may also reflect early treatment response, particularly for clinical signs, whereas LDH may reflect early and mid-term improvement of clinical signs.