Focused update: Guidelines of care for the management of atopic dermatitis in adults
- PMID: 40531067
- DOI: 10.1016/j.jaad.2025.05.1386
Focused update: Guidelines of care for the management of atopic dermatitis in adults
Abstract
Background: In 2023 and 2024, the American Academy of Dermatology published guidelines on the use of topical and systemic therapies for the management of atopic dermatitis (AD) in adults. Since the publication of these guidelines, several novel therapies have emerged to treat AD.
Objective: To update previous guidelines on the management of AD in adults by providing evidence-based recommendations on the use of additional Food and Drug Administration-approved topical and systemic therapies.
Methods: A multidisciplinary workgroup conducted a systematic review and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of evidence and formulating and grading recommendations.
Results: The workgroup developed 4 new recommendations for the management of AD in adults.
Limitations: This analysis is based on the best available evidence at the time it was conducted. Most randomized controlled trials of the considered therapies for AD are of short duration, limiting comparative long-term efficacy and safety conclusions.
Conclusions: The workgroup developed strong recommendations for the use of tapinarof cream, roflumilast cream, lebrikizumab, and nemolizumab with concomitant topical therapy.
Keywords: atopic dermatitis; biologic; eczema; lebrikizumab; nemolizumab; roflumilast; tapinarof; topical agents.
Copyright © 2025 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
Conflict of interest statement
Conflicts of interest David E. Cohen serves on the board of directors for Timber and Evommune receiving stock options and/or fees and as a consultant for Asana Biosciences, Ferndale Laboratories, Inc, Novartis, Facilitation of International Dermatology Education, Dermavant Sciences, Leo Pharma, Inc, UCB, and Cosmetic Ingredient Review receiving honoraria and/or stock options. Aaron M. Drucker receives research grants paid to his institution from the National Eczema Association, Eczema Society of Canada, Canadian Dermatology Foundation, Canadian Institutes for Health Research, US National Institutes of Health, and Physician Services Incorporated Foundation. Lawrence F. Eichenfield serves on the board of directors for Verrica Pharmaceuticals, Inc, receiving honoraria and/or stock options; as an investigator for AbbVie, Arcutis, Dermavant, Galderma Laboratories, National Eczema association, Pfizer, and Bausch without personal compensation (research grants to institution); as a consultant for AbbVie, Almirall, Amgen, Arcutis, Bausch, Bristol Meyer Squibb, Dermavant, Dermira, Eli Lilly, Forte, Galderma, Incyte, Janssen, Leo Pharma, Novartis, Ortho Dermatologics, Pfizer, Regeneron, and Sanofi Genzyme, receiving honoraria; and as an independent contractor for Elsevier, Inc receiving royalties. Amy S. Paller serves as a consultant for AbbVie, Abeona, Almirall, Amagma, Anaptysbio, Arena, Bausch, Bristol Myer Squibb, Dermavant, Dermira, Eli Lilly, Exicure, Forte, Leo, Lifemax, Novartis, Phoenix, Pierre Fabre, Pfizer, Rapt, Regeneron, Sanofi, Sol-Gel, UCB, and Venthera receiving honoraria and as an investigator for Anaptysbio, Eli Lilly, Incyte, Janssen, Krystal Bio, Lenus, Regeneron, and UCB receiving no compensation. Kathryn Schwarzenberger is the founder of Pretel, Inc and serves as a data safety monitoring board member for Pfizer, Inc receiving fees. Robert Sidbury serves as an advisory board member for Pfizer, Inc receiving honoraria; as a principal investigator for Regeneron receiving grants and research funding; as an investigator for Brickell Biotech, Inc and Galderma USA receiving grants and research funding; and as a consultant for Galderma Global and Microes receiving fees or no compensation. Jonathan I. Silverberg serves as an advisory board member for BioMX, Boehringer Ingelheim, RAPT Therapeutics, Celgene, Ortho Dermatologics, TARGET Pharma, AFYX Therapeutics, Corrona, Inc, Dermira, Pfizer, Inc, Leo Pharma, Inc, and Menlo Therapeutics receiving honoraria and/or fees; as an investigator for DS Pharma, TARGET Pharma, Kiniksa Pharmaceuticals, Ltd, Menlo Therapeutics, GlaxoSmithKline, AbbVie, Leo Pharma, Inc, and Regeneron receiving research funding, honoraria, or no compensation; as a consultant for AOBiome, Bluefin Biomedicine, Bodewell, BiomX, Inc, Galderma Research & Development, LLC, Arena Pharmaceuticals, Dermavant Sciences, Incyte Corporation, DS Biopharma, Sun Pharmaceutical Industries, Ltd, AnaptysBio, Asana Biosciences, LLC, Pfizer, Inc, Glenmark Generics, Inc, Sanofi, Kiniksa Pharmaceuticals, Ltd, GlaxoSmithKlein, Eli Lilly and Company, AbbVie, Regeneron, and Medimmune receiving honoraria or fees; and as a speaker for the Fall Clinical Dermatology Conference, Maui Derm, and Regeneron receiving honoraria or fees. Anne Marie Singh is an advisory board member for Incyte receiving honoraria. Peggy Wu is an author for UpToDate, Inc receiving honoraria. Drs Alikhan, Bercovitch, Davis, Frazer-Green, and Jennifer M. Darr have no conflicts of interest to declare.
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