Living with moderate-to-severe eczema, also known as atopic dermatitis, can be a relentless cycle of itching, inflammation, and frustration. When traditional creams and ointments fail to provide lasting relief, it’s easy to feel like you’ve run out of options. However, advancements in dermatology have led to a new class of treatments that work differently, targeting the specific sources of inflammation from within. One such treatment is Adbry (tralokinumab-ldrm), a biologic medication designed to manage the complexities of moderate-to-severe eczema.

This article provides a comprehensive overview of Adbry, explaining how it works, who it can help, and what to expect from treatment. The goal is to demystify this advanced therapy and show how it can be integrated into a personalized care plan to help you achieve clearer skin and lasting relief. At Honeydew, we believe in making expert care and clinically-proven treatments accessible, empowering you to take control of your skin health.

Understanding Eczema (Atopic Dermatitis)

Before diving into a specific treatment, it's helpful to understand the condition it addresses. Eczema, or atopic dermatitis, is more than just dry skin. It is a chronic inflammatory condition driven by an overactive immune response. In people with eczema, the immune system mistakenly attacks the skin, triggering a cascade of inflammation. This not only causes the visible symptoms but also damages the skin barrier—the protective outer layer responsible for keeping moisture in and irritants out.

A compromised skin barrier leads to the hallmark symptoms of eczema:

• Intense, persistent itching (pruritus): Often the most burdensome symptom, leading to a debilitating itch-scratch cycle that further damages the skin.
• Red, inflamed patches: These can appear anywhere on the body and may be accompanied by swelling.
• Dry, scaly, or thickened skin: Chronic inflammation can cause the skin to become leathery and cracked.
• Oozing or weeping blisters: In severe flare-ups, small, fluid-filled blisters can form.

The impact of moderate-to-severe eczema extends far beyond the skin. The constant itching can disrupt sleep, affect concentration at work or school, and take a significant toll on mental and emotional well-being. Many individuals feel self-conscious or socially isolated due to the appearance of their skin. At Honeydew, we recognize the profound effect this condition can have on your life, which is why our providers work with you to find a treatment plan that addresses both the physical symptoms and your overall quality of life.

What is Adbry and How Does It Work?

Adbry is not a cream or an ointment; it is a biologic medication. Understanding what that means is key to appreciating how it offers a different approach to managing eczema.

A Targeted Biologic Treatment

Biologics are a class of drugs derived from living organisms, such as cells or tissues. Unlike conventional synthetic drugs, which are created through chemical processes, biologics are large, complex proteins. In dermatology, they are engineered to act like components of the immune system, such as antibodies, to target very specific molecules involved in disease processes.

This precision is what sets Adbry apart from many traditional eczema treatments. While topical steroids reduce inflammation broadly on the skin's surface and older oral medications suppress the immune system as a whole, Adbry works from within to selectively neutralize a key driver of eczema-related inflammation. This targeted action helps restore balance to the immune system's response without widespread immunosuppression.

The Science Behind Adbry: Targeting IL-13

To understand how Adbry works, we need to look at the immune system's messengers, known as cytokines. Cytokines are proteins that signal cells to behave in certain ways. In atopic dermatitis, several cytokines are overproduced, but one, in particular, plays a central role: interleukin-13 (IL-13).

IL-13 is a major driver of the type 2 inflammation that characterizes atopic dermatitis. It is responsible for:

• Triggering itch and inflammation.
• Damaging the proteins that form a healthy skin barrier.
• Reducing the skin's ability to produce natural moisturizing factors.

Adbry is a monoclonal antibody specifically designed to find and neutralize the IL-13 cytokine. Think of it as a highly specialized heat-seeking missile. When injected, Adbry circulates through the body, binds directly to IL-13, and prevents it from attaching to its receptors on cells. By blocking this signal, Adbry effectively interrupts the inflammatory cycle at its source. This helps to reduce itch, clear skin, and allow the damaged skin barrier to begin repairing itself.

Who is a Good Candidate for Adbry?

Adbry is FDA-approved for adults and adolescents aged 12 and older with moderate-to-severe atopic dermatitis whose condition is not adequately controlled with topical prescription therapies or when those therapies are not advisable. But what does "moderate-to-severe" mean for a patient?

This classification generally applies when eczema:

• Covers a significant portion of the body.
• Does not respond sufficiently to first-line treatments like topical steroids or calcineurin inhibitors.
• Causes persistent and severe itching that disrupts daily activities and sleep.
• Has a significant negative impact on your overall quality of life.

The decision to start a biologic like Adbry is a collaborative one made between you and your healthcare provider. It requires a thorough evaluation of your medical history, the severity of your eczema, and previous treatments you've tried. At Honeydew, you can connect directly with a licensed provider over video to have this important conversation. Our expert care team will assess your unique situation to determine if an advanced biologic is the most appropriate and effective path forward for your personalized treatment plan.

The Adbry Treatment Process

Starting a new medication can feel daunting, especially an injectable one. Knowing what to expect can help make the process smoother and more manageable.

Starting and Administering Treatment

Adbry is administered as a subcutaneous injection, which means it is injected into the fatty tissue just under the skin, typically in the thigh, abdomen, or upper arm. The needle is small, and the injection process is something most patients quickly become comfortable with performing at home after initial training.

Treatment begins with a "loading dose," which is a higher initial dose intended to quickly bring the medication to an effective level in the body. For Adbry, this is typically four 150 mg injections (600 mg total) on the first day. After the loading dose, the maintenance dose is two 150 mg injections (300 mg total) every two weeks. For some patients, the provider may adjust the frequency to every four weeks once the condition is well-controlled.

What to Expect: Timeline for Results

Patience is important when starting any new treatment for a chronic condition. While some patients may notice a reduction in itch within the first few weeks, the primary clinical trials for Adbry focused on results at 16 weeks. By this point, a significant number of patients experienced substantial improvements in skin clearance and itch reduction. It is also important to know that results can continue to improve with ongoing treatment.

This is where Honeydew’s innovative approach to care becomes invaluable. Our online platform allows you to "Track your progress with photos and share with your care team online." This proven method enables your provider to visually monitor your skin's response to Adbry over time, ensuring the treatment is working as expected and allowing for timely adjustments to your care plan if needed. This continuous connection helps optimize your results and provides reassurance throughout your treatment journey.

Potential Benefits of Adbry for Eczema

The goal of treating moderate-to-severe eczema is not just to manage flare-ups but to achieve long-term control and improve quality of life. Adbry offers several key benefits in pursuit of this goal:

• Significant Itch Reduction: For many, the most life-altering benefit is relief from the relentless itch. By targeting IL-13, Adbry helps break the itch-scratch cycle, often providing relief faster than skin clearance.
• Clearer Skin: Adbry can lead to a dramatic reduction in the extent and severity of eczema rashes, with many patients achieving clear or almost clear skin.
• Targeted Action: Because it specifically targets IL-13, Adbry calms the underlying inflammation without broadly suppressing the entire immune system, offering a more focused approach than older systemic medications.
• Long-Term Management: Eczema is a chronic condition, and Adbry is designed for long-term use to keep symptoms under control and reduce the frequency and severity of flares.
• Improved Quality of Life: By reducing symptoms, patients often report better sleep, improved mental health, and greater confidence in their daily lives. A review of my skin by my mom on Honeydew even commented on my progress, a testament to the real-world impact.

Understanding Potential Side Effects

Every effective medication comes with potential side effects, and it's important to have a transparent discussion about them. Your provider will review your medical history to ensure Adbry is a safe choice for you. The most common side effects associated with Adbry are generally mild to moderate.

These include:

• Upper respiratory tract infections (common cold)
• Conjunctivitis (pink eye) and other eye-related issues like redness and itching
• Injection site reactions (redness, swelling, or itching at the injection site)
• Cold sores (herpes simplex virus infections)

The association with conjunctivitis is linked to the role IL-13 plays in the eye's surface tissues. Your provider can offer guidance on how to manage these symptoms if they occur. It is crucial to have a supportive care team you can turn to with questions. At Honeydew, you can "Access your care team around the clock for ongoing support." This direct line of communication ensures that any concerns about side effects are addressed promptly, and your treatment plan remains optimized for both safety and efficacy.

Adbry vs. Other Eczema Treatments

With more treatment options for eczema available than ever before, it's natural to wonder how they compare. The best choice is always individual and depends on a conversation with your provider, but here is a general comparison.

Adbry vs. Topical Treatments

Topical treatments like hydrocortisone, triamcinolone, and non-steroidal options like tacrolimus are the foundation of eczema care. They work by applying medication directly to the affected skin to reduce local inflammation. While effective for mild-to-moderate cases, they may not be sufficient for more severe, widespread disease. Adbry works systemically (from the inside out) to address the root cause of inflammation throughout the body. Topicals are often used in conjunction with Adbry to manage any remaining localized spots.

Adbry vs. Other Biologics (like Dupixent)

Dupixent is another widely used biologic for atopic dermatitis. The main difference lies in their targets. While Adbry specifically blocks IL-13, Dupixent blocks the signaling of both IL-13 and another cytokine, IL-4. Both are considered highly effective, and the choice between them can depend on a patient's specific medical profile, previous treatment responses, and provider expertise. Honeydew's clinicians are highly specialized medical professionals with experience in prescribing the full range of advanced biologics, ensuring you receive the one best suited to your needs.

Adbry vs. Traditional Oral Systemics

Older oral medications like methotrexate, cyclosporine, or prednisone work by broadly suppressing the immune system. While they can be effective, their lack of specificity can lead to a wider range of potential side effects and may require more intensive monitoring. The targeted nature of biologics like Adbry represents a significant advancement, offering a more precise way to control the disease with a potentially more favorable long-term safety profile.

The Honeydew Approach to Eczema Care

Living with moderate-to-severe eczema can be a frustrating journey of trial and error, moving from one cream to the next without finding lasting relief. At Honeydew, we understand the desire for a treatment that actually works. We are on a mission to make expert dermatological care and the most advanced treatments more accessible, convenient, and personalized for you.

If you are not satisfied with your current treatment, Honeydew offers the most personalized plans available to maximize results while minimizing side effects. For conditions like eczema and psoriasis, our providers are experts in prescribing cutting-edge biologics like Adbry, Dupixent, Skyrizi, and Tremfya that offer much more comprehensive relief.

Our 100% online care model is designed around your life, removing the barriers of travel and long wait times. Here’s how it works for a patient considering Adbry:

1. Meet Your Provider: You'll start with a video consultation with a licensed dermatology provider—a board-certified dermatologist, nurse practitioner, or physician assistant—from your phone or computer. You'll discuss your skin history, what you've tried, and your goals.
2. Get Your Personalized Treatment: Your provider will work with you to build a comprehensive treatment plan. If Adbry or another advanced therapy is right for you, we will prescribe it. We can work with your insurance to help get your medication covered and send the prescription to the right pharmacy.
3. Track Your Progress: We use proven methods to track your skin progress. Our online tools allow you to easily upload photos and communicate with your care team, so we can monitor your results and adjust your plan as needed to ensure you are getting better.
4. Ask Anything: Your membership includes ongoing support from your dedicated care team. You can message us anytime with questions about your medication, side effects, or anything else related to your skin. We're here for refills, support, and even lifestyle coaching.

Our expertise isn't limited to eczema. We help thousands of patients with a wide range of conditions, from persistent acne treated with personalized plans including Accutane or spironolactone, to psoriasis and beyond. By combining expert care with the convenience of telemedicine, we help you stay on top of your treatment and achieve the real, life-changing results you deserve. If you're ready to explore a modern, personalized approach to managing your eczema, get started with Honeydew today.