Review of Tralokinumab in the Treatment of Atopic Dermatitis
Abstract
Objective To review pharmacokinetics, efficacy, and safety of tralokinumab in treatment of atopic dermatitis (AD). Data Sources Literature review was conducted using MEDLINE (PubMed), EMBASE, and ClinicalTrials.gov for articles published between January 2010 and May 2022. Study selection and data extraction Articles in English discussing tralokinumab in AD were included. Data synthesis In one phase 2 trial, more subjects treated with tralokinumab 150 and 300 mg achieved an Investigator’s Global Assessment (IGA) of 0/1 with minimum ≥2 point IGA reduction (23%), versus placebo (11.8%, P = 0.10). During 2 phase 3 trials, more subjects treated with tralokinumab achieved IGA success (ECZTRA 1: 15.8% and ECZTRA 2: 22.2%), versus placebo (7.1% and 10.9%, respectively; P = 0.002 and P < 0.001). During one phase 3 trial, in conjunction with topical corticosteroids (TCS), more subjects treated with tralokinumab 300 mg achieved IGA success (ECZTRA 3: 38.9%), versus placebo (26.2%, P = 0.015). During another phase 3 trial in subjects with resistance or contraindication to oral cyclosporine, more subjects treated with tralokinumab 300 mg achieved an Eczema Area Severity Index 75 (64.2%), versus placebo (50.5%, P = 0.018). Relevance to patient care and clinical practice Tralokinumab is efficacious for moderate-to-severe AD, as monotherapy, in conjunction with TCS, and resistance or contraindication to cyclosporine. Although IL-4 and IL-13 are both implicated in AD’s pathogenesis, IL-13 is overexpressed, and head-to-head trials are needed to assess efficacy of tralokinumab, versus dupilumab. Compared with upadacitinib and abrocitinib, tralokinumab is not associated with black-box warnings. Conclusions Tralokinumab is an efficacious and safe systemic treatment for moderate-to-severe AD.
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Topical corticosteroids and calcineurin inhibitors remain first-line treatments for atopic dermatitis, while topical JAK inhibitors provide targeted inhibition of cytokine signaling downstream of IL-4 and IL-13.
“Topical anti-inflammatory therapies, including corticosteroids and calcineurin inhibitors, remain first-line treatments, while topical JAK inhibitors provide targeted inhibition of cytokine signaling downstream of IL-4 and IL-13.”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [14]
Treatment of atopic dermatitis targets epidermal barrier dysfunction and type 2 immune dysregulation.
“Treatment of atopic dermatitis targets the epidermal barrier dysfunction and type 2 immune dysregulation.”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [14]
Emollients and ceramide-based moisturizers restore lipid composition, reduce transepidermal water loss, and limit allergen and microbial penetration.
“Management includes both barrier repair options and targeted immunomodulation, with emollients and ceramide-based moisturizers, which restore lipid composition, reduce transepidermal water loss, and limit allergen and microbial penetration.”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [14]
In moderate-to-severe atopic dermatitis, systemic immunosuppressants such as cyclosporine, methotrexate, azathioprine, and mycophenolate mofetil can be used, alongside oral JAK inhibitors that interfere with intracellular signaling pathways central to disease pathogenesis.
“In moderate-to-severe disease, systemic immunosuppressants can be used, such as cyclosporine, methotrexate, azathioprine, and mycophenolate mofetil, alongside oral JAK inhibitors that interfere with intracellular signaling pathways central to disease pathogenesis.”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [14]
These atopic dermatitis therapies reduce inflammation and contribute to restoration of barrier function.
“These therapies reduce inflammation and contribute to the restoration of barrier function.”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [14]
Biologic therapies targeting type 2 inflammation, including dupilumab, lebrikizumab, and tralokinumab, have shown significant efficacy in moderate-to-severe atopic dermatitis by inhibiting IL-4 and IL-13 signaling.
“Biologic therapies targeting type 2 inflammation, including dupilumab, lebrikizumab, and tralokinumab, have shown significant efficacy in moderate-to-severe atopic dermatitis by inhibiting IL-4 and IL-13 signaling [11,12,13,14,15].”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [14]
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- Authors
- Singh, R., Taylor, A., Shah, M. A., Strowd, L. C., & Feldman, S. R.
- Affiliations
- Wake Forest University Health Sciences (US)
- Corresponding author
- Singh, Rohan
- Venue
- Annals of Pharmacotherapy
- Publisher
- SAGE Publications
- Published
- 2022-06-22
- Volume
- 57
- Issue
- 3
- Pages
- 333-340
- ISSN
- 0012-6578 (ISSN-L)
- 1060-0280
- 1542-6270
- OpenAlex
- W4283325016
- Cited by
- 10
- References
- 27
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 3
- FWCI
- 0.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Pharmacotherapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
- Keywords
- tralokinumab, atopic dermatitis, IL-4 receptor alpha inhibition, IL-13, topical corticosteroids, dupilumab, pharmacokinetics, drug safety, moderate-to-severe atopic dermatitis
- MeSH terms
- Antibodies, Monoclonal, Dermatitis, Atopic, Dermatologic Agents, Double-Blind Method, Glucocorticoids, Humans, Immunoglobulin A, Severity of Illness Index, Cyclosporine, Treatment Outcome, Interleukin-13
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