Atopic Dermatitis

AAD 2025. Peter Lio, MD, from the Feinberg School of Medicine in Chicago, previewed his presentation on atopic dermatitis and diet, before the 2025 AAD meeting.

Panelists discuss how proper application technique and adherence are vital for topical atopic dermatitis treatments. Effective provider communication and primary care provider/dermatologist collaboration optimize patient outcomes through education and coordinated care. Primary care providers and dermatologists should coordinate care through clear communication, shared protocols, and defined referral pathways to optimize atopic dermatitis management and improve patient outcomes.

Panelists discuss how, based on clinical observations, atopic dermatitis imposes significant physical and mental burdens. Patients experience chronic itching, pain, and sleep disruption while experiencing psychological distress, social anxiety, and reduced self-esteem. Delayed diagnosis exacerbates these burdens, allowing disease progression and worsening quality of life.

Panelists discuss recent topical atopic dermatitis therapies, which include roflumilast (PDE4 inhibitor, age ≥ 6 years), ruxolitinib (JAK inhibitor, age ≥ 12 years), and tapinarof (hydrocarbon receptor agonist, age ≥ 2 years). Treatment selection considers disease severity, age, affected areas, comorbidities, and previous therapy responses.

Panelists discuss how the newer topical agents (PDE4 inhibitors, JAK inhibitors) demonstrate comparable efficacy to midpotency corticosteroids but with improved safety profiles, lacking steroid-related adverse effects such as skin atrophy, hypothalamic-pituitary-adrenal axis suppression, and tachyphylaxis when used long term.

Panelists discuss how older topical treatments such as corticosteroids, calcineurin inhibitors, and crisaborole have limited efficacy with prolonged use. Corticosteroids cause skin thinning and systemic absorption on large body surface area (BSA). Calcineurin inhibitors and crisaborole show modest efficacy, with application site reactions.

Panelists discuss how atopic dermatitis diagnosis in primary care relies on clinical features including pruritus, characteristic distribution, and chronic/relapsing course. Severity assessment involves examining extent, intensity, impact on quality of life, and response to previous treatments.

The FDA has set a PDUFA target action date for October 13, 2025, according to Arcutis Biotherapeutics.

Investigators reported that roflumilast cream 0.05% significantly reduced AD severity as early as Week 1, with a notable effect on pruritus seen in as little as 24 hours.

Treatment of AD with dupilumab, compared with cyclosporine and methotrexate, was associated with significantly reduced risk of a wide range of CV outcomes at 1 year.

The clearance enables Alphyn to initiate global phase 2b clinical trials, which are anticipated to begin in the first quarter of 2025.

Rezpegaldesleukin targets the IL-2 receptor complex to stimulate regulatory T cells, aiming to restore immune balance in people with atopic dermatitis.

The investigational molecule with “JAK-inhibitor-like efficacy and IL4/IL13-like safety,” was cleared in Q4 2024 by the FDA for an IND application, the company said.

A first large-scale comparison of length of treatment with advanced AD therapies also identified reasons for discontinuation and examined prior use of biologics and JAK inhibitors.

Improvement in AD signs and symptoms continued through 56 weeks of treatment with the PDE4 inhibitor including when used just twice weekly as prophylaxis.

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Tapinarof 1% cream when used as topical monotherapy led to statistically significant and sustained improvements in QoL, sleep, and other PROs across age groups.

There are no diagnostic criteria for topical steroid withdrawal but patients describe and discuss it on social media. Study authors tapped a deep source of information.

Findings showed that improved skin clearance and reduced anxiety and depression significantly influenced perceived patient benefit.

Early proof-of-concept phase 1a data from the trial is anticipated in the third quarter of 2025.

Nektar Therapeutics announced the milestone in its clinical program to evaluate the IL-2 receptor agonist, a potential first-in-class treatment for the chronic condition.

Intravenous IMG-007 at study weeks 0, 2, and 4 led to a mean reduction in EASI of 77% as early as week 4; more than half of participants reached EASI-75 at week 16.

Not all atopic dermatitis requires treatment by a specialist, says this dermatologist, and she collaborates regularly with her primary care colleagues.