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IL-13 Inhibitor — Atopic Eczema Pregnancy: Limited data from use in pregnant women; animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity. As a precautionary measure it is preferable to avoid use during pregnancy. Breast-feeding: unknown whether excreted in human milk — decide whether to discontinue breast-feeding or treatment.

Tralokinumab

Brand names: Adtralza

Tralokinumab is a fully human monoclonal antibody used as a subcutaneous biologic treatment for moderate-to-severe atopic dermatitis (eczema) in patients inadequately controlled by topical therapy.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Initial dose 600 mg (four 150 mg injections), followed by 300 mg (two 150 mg injections)
Route: Subcutaneous injection into the thigh or abdomen (except the 5 cm around the navel); the upper arm may also be used if someone else administers the injection
Frequency: 600 mg initial dose, then 300 mg every other week
eMC (Adtralza 150 mg solution for injection in pre-filled syringe). The same regimen applies to adult and adolescent patients 12 years and older. At the prescriber's discretion, every fourth week dosing may be considered for patients who achieve clear or almost clear skin after 16 weeks of treatment, although the probability of maintaining clear or almost clear skin may be lower with every fourth week dosing. Consider discontinuing treatment in patients who have shown no response after 16 weeks; some patients with an initial partial response may improve further with continued every-other-week treatment beyond 16 weeks. For patients with high body weight (>100 kg) who achieve clear or almost clear skin after 16 weeks, reducing to every fourth week might not be appropriate. Treatment should be initiated by healthcare professionals experienced in the diagnosis and treatment of atopic dermatitis. Can be used with or without topical corticosteroids; topical calcineurin inhibitors may be used but should be reserved for problem areas only. For the initial 600 mg dose, four 150 mg pre-filled syringes should be administered consecutively at different injection sites within the same body area; rotate the injection site with each dose. Allow pre-filled syringes to reach room temperature for 30 minutes after removal from the refrigerator; do not shake. Missed dose: administer as soon as possible, then resume the regular schedule. Elderly: no dose adjustment recommended (limited data >75 years). Paediatric: safety and efficacy in children below 12 years have not been established — no data available.

Dose adjustments

Renal

No dose adjustment is needed in patients with renal impairment; very limited data are available in severe renal impairment. No dose adjustment is needed in hepatic impairment.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Hypersensitivity to the active substance or to any of the excipients

Side effects

  • Upper respiratory tract infections — very common (23.4%), mainly reported as common cold
  • Injection site reactions — common (7.2%)
  • Conjunctivitis — common (5.4%)
  • Allergic conjunctivitis — common (2.0%)
  • Eosinophilia — common
  • Keratitis — uncommon

Interactions

  • Live and live attenuated vaccines should not be given concurrently — clinical safety and efficacy have not been established; bring patients up to date with live/live attenuated immunisations before initiating treatment
  • Inactivated / non-live vaccines may be given concurrently — antibody responses to tetanus and meningococcal vaccines were similar to placebo, with no adverse interactions noted

Clinical monograph

How it works

It specifically binds the cytokine interleukin-13 (IL-13), preventing it from engaging its receptors and thereby dampening the type 2 inflammatory signalling that drives atopic dermatitis.

Prescribing in practice

  • Live vaccines should be avoided during treatment because of the immunomodulatory effect; ensure age-appropriate immunisations are up to date beforehand.
  • Conjunctivitis and keratitis are recognised adverse effects; advise patients to report new or worsening eye symptoms.
  • Reserve for moderate-to-severe disease in line with NICE criteria, and review response after an adequate trial as set out in current prescribing references.

Monitoring

Assess clinical response (such as disease severity scores) periodically and monitor for ocular adverse effects and signs of hypersensitivity.

Counselling the patient

  • This is a long-term injection given under the skin; you may be taught to self-inject at home.
  • Tell your clinician promptly if you develop sore, red or watery eyes.
  • Continue your usual emollients and any prescribed topical treatments unless advised otherwise.

Evidence & guidelines

NICE has issued technology appraisal guidance supporting tralokinumab for moderate-to-severe atopic dermatitis where conventional systemic therapy is inadequate or unsuitable.

Reference: ECZTRA-3 Trial (Wollenberg et al. NEJM 2021); NICE TA869; SPC Adtralza; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.