For people living with atopic dermatitis, the real test of any new therapy is not what it can do in a few months, but whether it can keep angry, inflamed skin quiet over the long haul. Nektar Therapeutics now has one year of data suggesting its experimental shot, rezpegaldesleukin, can do exactly that, with a surprising twist: responses did not fade with time, they deepened. The 52-week REZOLVE-AD study points to a drug that may keep skin clear and under control with far fewer injections than today’s leading biologics.
The stakes are high. Moderate-to-severe eczema is not just a cosmetic nuisance, it is a chronic inflammatory disease that disrupts sleep, work, school and mental health. When a therapy can move patients from constant flares to near-complete clearance, and then hold that line for a year, it changes daily life in ways that are hard to capture in a single efficacy percentage.
What the 52-week REZOLVE-AD data actually show
The REZOLVE-AD trial is a global, randomized phase 2 study designed to test rezpegaldesleukin in adults with moderate-to-severe atopic dermatitis who were not adequately controlled on topical treatments. After a 16-week induction period, responders were re-randomized to different maintenance schedules, creating a real-world test of whether the drug’s effect could be sustained over a full 52-Week period. The sponsor describes REZOLVE-AD as a pivotal proof-of-concept step, with the maintenance data now carrying as much weight as the initial response rates.
Earlier this year, detailed maintenance results showed that skin clearance did not simply plateau. In the re-randomized group, EASI-100, a measure of complete or near-complete clearance, rose from 4% to 22% with quarterly (Q12W) dosing and from 9% to 18% with monthly (Q4W) dosing, according to an analysis that highlighted how responses continued to deepen rather than flatten out over time. That pattern, described in coverage of Rezpegaldesleukin Shows Deepening, is unusual in chronic inflammatory disease, where the more common story is early gains followed by slow erosion.
Durability, new responders and the escape arm question
One of the most intriguing aspects of the REZOLVE-AD design is what happened to people who did not respond early. Patients who failed to reach an EASI-50 threshold during the 16-week induction were not simply dropped; instead, these Patients were moved into a treatment escape arm for up to 36 weeks, giving the drug more time to work in harder-to-treat disease. The company’s own description of this escape pathway, which required an EASI improvement of at least 50, underscores an ambition to capture late responders rather than write them off as failures in the headline analysis, as detailed in the trial’s maintenance release.
That design choice cuts both ways. On one hand, it reflects clinical reality, where dermatologists often continue a promising therapy beyond an arbitrary week-16 cutoff if a patient is trending in the right direction. On the other, it complicates interpretation of durability, because the headline maintenance cohort is enriched for early responders while late responders are funneled through a different path. Some analysts have already questioned whether this structure overstates long-term robustness, a concern echoed in a Dive Brief that noted how non-responders were effectively removed from the main durability narrative. I see the escape arm as a reasonable compromise, but it means phase 3 will need cleaner, pre-specified analyses of both early and late responders to convince regulators and payers.
How rezpegaldesleukin is changing Nektar’s trajectory
For Nektar, these eczema data are not just a scientific milestone, they are a corporate lifeline. The company has been trying to reset expectations after earlier pipeline disappointments, and its stock had fallen more than 40% since November ahead of the one-year readout, according to an analysis of Nektar Therapeutics. That kind of drawdown reflects deep skepticism about whether the company could deliver a competitive asset in a crowded atopic dermatitis market.
The new data have started to reverse that narrative. Commentators now describe the eczema candidate as having “checked all of the boxes” in long-term phase 2, pointing to consistent efficacy, a manageable safety profile and the convenience of monthly or quarterly dosing. That phrase, attached to Nektar, signals a shift from survival mode to genuine competitive positioning. I expect the company to lean heavily on this one-year durability story as it negotiates partnerships, raises capital and designs phase 3, because in a market dominated by incumbents, differentiation on dosing and long-term control is the clearest path to commercial relevance.
Stacking up against Dupixent and a crowded eczema field
Any new systemic eczema therapy will inevitably be compared to Dupixent, the every-two-week injection that has reset expectations for what atopic dermatitis control can look like. Rezpegaldesleukin is not yet in a head-to-head trial, so direct efficacy comparisons are unverified based on available sources, but the dosing schedule alone creates a different proposition. A shot every four or twelve weeks is a different psychological and logistical burden than one every two weeks, especially for patients juggling other chronic medications. Reports describing the REZOLVE-AD Trial Design emphasize that the study was built to test both Q4W and Q12W maintenance, with the REZOLVE framework explicitly focused on long-term control rather than short-term flare suppression, as outlined in coverage of the Term Durability of the Week AD Trial.
From a patient’s perspective, the difference between a biweekly injection and a quarterly one is like the gap between refueling a car every few days and driving a hybrid that only needs a gas station visit every few months. It does not change the destination, but it can dramatically alter how stressful the journey feels. That is why I think the most important next step is not just to show non-inferiority on skin scores, but to quantify quality-of-life gains, including sleep, work productivity and mental health, in a way that resonates with both clinicians and insurers. Early symptom data, including improvements in itch and overall EASI scores reported Among re-randomized participants in the REZOLVE-AD analysis, hint at this broader impact, with EASI-100 response rates rising alongside patient-reported outcomes in the cohort described by Among EASI.
Partnerships, safety gaps and what comes next
Rezpegaldesleukin is not a solo act. Nektar has partnered with Evommune to advance the program, a collaboration that reflects how mid-cap biotechs increasingly share risk and expertise in complex immunology. Recent reporting on the eczema program notes that the Eczema drug from Nektar Therapeutics maintained skin responses over one year in the REZOLVE-AD study, and that There is growing interest in how this mechanism might extend to related inflammatory conditions, as described in a detailed STAT analysis. That partnership structure also sets up a clear division of labor for the expensive phase 3 and commercialization work that lies ahead.
Safety, however, remains the biggest open question. The 52-week data suggest a tolerable profile without obvious new safety signals, but rare adverse events and long-term immune modulation risks will only emerge in larger, more diverse populations. The company’s own maintenance summary emphasizes that rezpegaldesleukin resulted in durable and new responses across key disease measurements with both monthly and quarterly dosing, including in patients with co-morbid asthma, but it does not yet provide the kind of granular, multi-year safety breakdown that regulators and payers will eventually demand. My expectation is that phase 3 will be paired with an extension study of at least two years, tracking not only skin scores but also healthcare utilization, such as emergency visits for flares and systemic steroid use, to test the hypothesis that deeper, more durable control can bend the cost curve.
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*This article was researched with the help of AI, with human editors creating the final content.
