For patients with atopic dermatitis (AD) enrolled in the ECZTEND trial and receiving tralokinumab, COVID-19 infections were mainly mild or moderate and almost all occurred in unvaccinated patients, according to a research letter published online Oct. 12 in JAMA Dermatology .

Andrew Blauvelt, M.D., from Oregon Medical Research Center in Portland, and colleagues conducted a case series in a subset of adults enrolled in the ongoing ECZTEND trial who received 300 mg subcutaneous tralokinumab every two weeks plus optional topical corticosteroids after a 600-mg loading dose and reported COVID-19 during routine clinic visits. Of 1,442 patients enrolled in the ECZTEND trial, 77 had confirmed COVID-19 (76 were unvaccinated and one was partially vaccinated).

The researchers found that COVID-19 severity was mainly mild or moderate (68 and 30 percent, respectively); two patients (3 percent) had severe symptoms, both of whom had multiple risk factors for severe COVID-19 and both of whom recovered after hospitalization. Neither case was reported as linked to treatment with tralokinumab. Two cases of COVID-19 were reported as possibly associated with tralokinumab; both occurred in patients younger than 30 years. No deaths were reported from COVID-19. After COVID-19, all patients continued tralokinumab therapy; treatment was not interrupted in 60 patients (78 percent). As of April 30, 2021, 16 percent of participants in the trial had received one or more COVID-19 vaccine doses; no patients reported adverse events resulting in permanent discontinuation of tralokinumab after vaccination.

"No new safety signals or evidence for reduced effectiveness of severe acute respiratory syndrome coronavirus 2 vaccines administered during tralokinumab treatment were reported," the authors write.

Several authors disclosed financial ties to biopharmaceutical companies, including Leo Pharma, the manufacturer of tralokinumab.

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