Atopic dermatitis is more than a skin condition; it can cause significant psychological stress, sleep disruption, and limits on daily activities. When it appears on visible areas such as the hands, the impact is even more severe. Because these areas cannot be concealed, patients often experience heightened embarrassment and anxiety, resulting in a further decline in quality of life.

Against this backdrop, new data from the global Phase 3b ADHAND study show that the IL-13 inhibitor Adtralza (tralokinumab) offers an effective new option for patients with hand atopic dermatitis. The study provides evidence that targeting IL-13 can deliver meaningful improvement and symptom relief for this population.

Professor Pablo Manso visited Korea to present interim clinical results and real-world treatment cases of tralokinumab, demonstrating its therapeutic potential not only for the face and neck but also for the hands, at the Annual Meeting of the Korean Atopic Dermatitis Association.

Hit News spoke with Professor Pablo Manso, a dermatologist at La Princesa University Hospital in Spain and an investigator in this study, for an in-depth discussion on tralokinumab’s mechanism of action and its clinical value.

"While exact statistics are lacking, more than half of patients with atopic dermatitis have lesions on their hands, and roughly one-third of those cases fall into the moderate to severe range.

The first reason hand involvement is so difficult to treat is constant exposure. Hands are continuously in contact with external environments and irritants. Because they cannot be fully protected, the condition easily becomes chronic, making effective treatment challenging.

Another factor is the unique nature of hand skin. The skin on the hands is significantly thicker than other areas of the body, and the inflammatory response tends to persist longer. In other words, the inflammatory profile is different, which adds complexity to treatment. I see these factors as the fundamental reasons hand atopic dermatitis is particularly difficult to manage."

"Involvement of highly visible areas—such as the hands, face, or neck—has a profound emotional and social impact. These are areas patients cannot hide, and they influence how others interact with them, how they work, and even how they perceive themselves. Many patients report embarrassment, anxiety, and avoidance of social or professional situations. This is why controlling symptoms in exposed areas is especially meaningful; visible improvement directly enhances confidence and overall quality of life."

"The ADHAND study is a global Phase 3b clinical trial evaluating tralokinumab in adults with moderate to severe atopic dermatitis affecting the hands. It was a randomized, double-blind, placebo-controlled study involving patients who were candidates for systemic therapy and had inadequate response to topical treatment. Participants received a 600 mg loading dose followed by 300 mg every two weeks. Outcomes at Week 16 were compared with placebo, and a 32-week extension phase is ongoing.

The primary endpoint was the proportion of patients achieving clear or almost clear skin on the hands at Week 16 (IGA-AHE 0 or 1). Key secondary endpoints included improvement in hand eczema severity (HECSI-75, HECSI-90), reduction in itch and pain scores, and quality-of-life measures such as DLQI and HEIS."

"The 16-week interim data are highly clinically relevant. Tralokinumab delivered rapid, consistent, and meaningful improvement, meeting the primary and all secondary endpoints.

Approximately 40% of patients achieved clear or almost clear skin on the hands (IGA 0/1), compared with about 10% in the placebo group. Nearly two-thirds reached HECSI-75, meaning a ≥75% reduction in hand eczema severity. Importantly, these improvements were accompanied by marked reductions in itch, pain, and quality-of-life scores. The safety profile was comparable to placebo, with no new safety signals—an excellent outcome."

"While the exact mechanism is not fully defined, a consistent finding across biologic therapies—including tralokinumab—is the restoration of cell-adhesion proteins that form the skin barrier. Tralokinumab appears to help recover these proteins, allowing the skin to retain moisture and better protect itself from external irritants.

As inflammation resolves, the overall skin environment improves, and this may lead to epigenetic changes that restore the expression and function of key proteins. In other words, tralokinumab does more than suppress inflammation—it supports structural recovery of the skin itself. This contributes to reduced moisture loss, prevents penetration of external substances, and is supported by growing biological evidence."

"Tralokinumab is already in use in Spain. The first point I want to emphasize is its safety. Having worked with many therapies, I consider tralokinumab one of the safest biologics I have used.

In terms of effectiveness, adverse events seen with other agents—such as facial erythema—were rarely observed after switching patients to tralokinumab. In many cases, we were able to “rescue” patients who had issues with competing treatments. A significant number of patients showed noticeable improvement within a short period, and the level of improvement was remarkable."

"Several studies have already confirmed the systemic benefits of tralokinumab, but this research is particularly valuable because it demonstrates effectiveness in a localized area that is both unique and notoriously difficult to treat.

Tralokinumab specifically neutralizes IL-13 and is associated with a notably lower rate of adverse events such as conjunctivitis. This means the new data provide a strong rationale for using tralokinumab as a first-line biologic in patients with severe hand involvement or those who experienced worsening of special areas or adverse effects—such as conjunctivitis—on previous therapies."

"We have long and very positive clinical experience with tralokinumab. It has proven to be a reliable and well-tolerated therapy—a true long-term partner in disease management. The ADHAND study shows that its value extends even to special, hard-to-treat areas like the hands, confirming that IL-13 targeting can deliver strong and consistent results not only in widespread disease but also in localized forms of atopic dermatitis that significantly impact patients’ lives."