lebrikizumab: clinical use

Prescribing considerations

• Initiation should be by clinicians experienced in diagnosing and treating atopic dermatitis.
• Review immunisation status before treatment and complete age-appropriate vaccination where appropriate; avoid concurrent live vaccines.
• Treat pre-existing helminth infection before starting. If infection develops and does not respond to treatment, interrupt lebrikizumab until it resolves.
• Use caution with significant ocular disease or previous systemic hypersensitivity.
• Record the product name and batch number for traceability.

Contraindications and cautions

• Hypersensitivity to lebrikizumab or any formulation excipient.

Monitoring

• Clinical response and continuing need for treatment
• New or worsening conjunctivitis, keratitis, blepharitis, eye pain or visual change
• Systemic hypersensitivity, including delayed reactions
• Symptoms of helminth infection or shingles
• Product name and batch number for each administration

Clinical pharmacology

Lebrikizumab selectively neutralises IL-13 signalling through the IL-4Rα/IL-13Rα1 heterodimer. As an IgG monoclonal antibody, it is expected to undergo proteolytic catabolism rather than significant renal, hepatic or cytochrome-mediated elimination.

Formulation and product differences

• Single-use, ready-to-inject pre-filled glass syringe with an automatic needle-safety device.
• The solution should be clear to opalescent and colourless to slightly yellow or slightly brown, without visible particles.
• Contains polysorbate 20, which may cause allergic reactions.
• Keep refrigerated, do not freeze or shake, and protect from light. Once removed from refrigeration, it may be kept at up to 30°C for seven days and must not be returned to the refrigerator.

Injection

Route: Parenteral

Strengths: 250 mg