AAD 2026 Insights: Expanding Targets, Faster Responses, and Durable Control in Atopic Dermatitis Management

New data presented at the 2026 American Academy of Dermatology (AAD) Annual Meeting in Denver, Colorado, highlighted substantial advances in atopic dermatitis (AD), spanning topical, biologic, and systemic approaches. Across multiple studies, investigators reported earlier onset of action, sustained long-term disease control, and improved patient-reported outcomes tied to more stringent treatment targets.

Emerging therapies demonstrated efficacy in traditionally challenging populations, including pediatric patients, infants, and patients with skin of color or difficult-to-treat anatomic involvement. As many presenters noted, these findings reinforce a shift toward treat-to-target strategies, precision selection of therapies, and a growing emphasis on durability, safety, and meaningful symptom relief in routine clinical practice.

Below, you’ll find a collection of Dermatology Times’ on-site coverage of AD updates from AAD 2026.

Tapinarof in Pediatric AD

A post hoc pooled analysis of the ADORING 1 and 2 phase 3 trials evaluated early efficacy of tapinarof cream 1% in 813 patients aged ≥2 years with moderate to severe AD, approximately 80% of whom were pediatric. Tapinarof demonstrated statistically significant improvements versus vehicle as early as week 1 across multiple endpoints. vIGA-AD response was achieved in 5.8% versus 1.6% (P=0.0315), and EASI 75 in 9.0% versus 3.3% (P=0.0164). Clinically meaningful pruritus reduction (≥4-point decrease) occurred in 18.8% versus 11.3% (P=0.0128). Responses increased through week 8, with EASI 75 rates of 57.4% versus 22.1% and pruritus improvement in 59.3% versus 33.5% (both P<0.0001). Notably, 96.9% of treated patients achieved some EASI improvement by week 8. Safety findings were consistent with prior reports, supporting tapinarof’s role as a steroid-free topical option with early onset of action.¹

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Nemolizumab in Pediatric Patients

Late-breaking phase 2 data evaluated nemolizumab, an IL-31–targeting monoclonal antibody, in pediatric patients aged 2 to 11 years with moderate to severe AD. The trial utilized a gated cohort design to achieve pharmacokinetic exposures comparable to older populations, with dose optimization across age groups. Baseline disease burden was substantial, with most patients classified as moderate and approximately one-quarter as severe. At week 16, approximately 47% of patients achieved clear or almost clear skin, with EASI 75 responses nearing 70% and EASI 90 exceeding 50%. Efficacy improved through week 52, with EASI 90 rates reaching the high 60% to 70% range. Rapid pruritus reduction was observed as early as week 1 in a majority of patients. Nemolizumab was well tolerated, with a safety profile consistent with prior studies, supporting its potential as a targeted option for pediatric AD, particularly for itch-dominant disease.²

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Roflumilast as a Topical for Infants

Phase 2 data from the INTEGUMENT-INFANT study evaluated once-daily roflumilast cream 0.05% in infants aged 3 months to <24 months with mild to moderate AD. Among 101 enrolled patients (96 completers), 34.4% achieved vIGA-AD success at week 4, with 49% reaching clear or almost clear skin; early responses were observed by week 2 in 24%. Efficacy was supported by EASI outcomes, with 58.3% achieving EASI 75 at week 4 (34% at week 2), indicating rapid and progressive improvement. Notably, 67.5% of infants with baseline scalp involvement achieved vIGA-scalp success, highlighting utility in sensitive areas. Pruritus reduction was robust, with 72.7% achieving ≥4-point improvement on WSI-NRS by week 4 and rapid itch relief was observed within minutes to hours post-application. Roflumilast was well tolerated, with minimal adverse events and excellent local tolerability. These findings support its potential as a nonsteroidal topical PDE4 inhibitor for infantile AD.³

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Lebrikizumab for Adolescents and Adults

Interim results from the ADlong phase 3b extension study demonstrate durable efficacy of lebrikizumab in adolescents and adults with moderate to severe AD, with outcomes assessed at week 48 representing up to 4 years of cumulative exposure. Among 174 prior responders, 94% achieved EASI 75, 75% reached EASI 90, and 68% attained IGA 0/1. Sustained itch control was reported in 78% of patients (Pruritus NRS ≤4). Notably, these outcomes were largely maintained without adjunctive therapy, with 80% of patients not requiring topical corticosteroids and 77% receiving lebrikizumab monotherapy; most were managed on monthly dosing. Safety findings remained consistent with earlier trials, with no new signals identified. These data support the long-term durability and tolerability of IL-13 inhibition, reinforcing lebrikizumab as a viable maintenance strategy in chronic AD management.⁴

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Tralokinumab in Patients With Skin of Color

Final 12-month data from the TRACE real-world program demonstrate sustained effectiveness of tralokinumab in adults with moderate to severe AD across diverse and high-burden subpopulations. In patients with skin of color (Fitzpatrick IV–VI; n=131), 60.7% achieved IGA 0/1, with parallel improvements in pruritus (6.8 to ~3.0) and DLQI (13.5 to 5.6). Across the full cohort (n=824), 91% achieved ≥1 moderate and 78% ≥1 optimal minimal disease activity target, with approximately three-quarters meeting combined clinician- and patient-reported moderate thresholds. Among patients with hand and/or foot involvement (n=495), 57.4% had complete clearance in these regions and 60% reached IGA 0/1. Safety was consistent with prior experience. These findings support durable IL-13 inhibition with tralokinumab in routine practice, including in traditionally difficult-to-treat populations.^5-7

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Confusing Allergic Contact Dermatitis for AD in Kids

Emerging clinical insights highlight that allergic contact dermatitis (ACD) in pediatric patients is underrecognized and may be misdiagnosed as AD, with implications for inappropriate long-term therapy escalation. Increased utilization of patch testing and heightened awareness of allergen exposure are shifting diagnostic approaches. Clinicians are advised to consider ACD in children presenting with atypical or treatment-refractory eczema and to systematically evaluate potential contact triggers. Failure to identify ACD may result in unnecessary use of topical corticosteroids or systemic agents. Management is anchored in allergen avoidance, the only definitive intervention, although topical therapies (eg, corticosteroids, PDE4 inhibitors, JAK inhibitors) may provide symptomatic control when avoidance is incomplete. In more severe or refractory cases, biologics or systemic JAK inhibitors may be considered. Data gaps remain regarding the natural history and persistence of contact sensitization over time.⁸

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Amlitelimab as the Next OX40-Ligand Inhibitor

Phase 3 data from the COAST 1, COAST 2, and SHORE trials demonstrate that amlitelimab, an anti-OX40L monoclonal antibody, provides incremental efficacy through week 24 in adolescents and adults with moderate to severe AD without evidence of plateau. Monotherapy trials showed vIGA-AD 0/1 rates of approximately 21% to 26% versus 9% to 15% with placebo, with EASI 75 responses of 36% to 39%. Combination therapy with topical corticosteroids yielded higher responses, with vIGA-AD 0/1 up to 32% and EASI 75 approaching 48%. Clinically meaningful itch reduction was consistently greater with amlitelimab across studies. Notably, every-12-week dosing demonstrated efficacy comparable to every-4-week administration. Safety was consistent with prior data, with no new signals identified. These findings support upstream T-cell modulation via OX40L inhibition as a potentially durable therapeutic strategy in AD.⁹

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Supporting JAK Safety

Clinical perspectives on Janus kinase (JAK) inhibitors in dermatology suggest that safety concerns related to boxed warnings may be overstated in the context of AD. The elevated risks of major adverse cardiovascular events, malignancy, and venous thromboembolism were primarily observed in the ORAL Surveillance trial in rheumatoid arthritis, rather than in AD-specific studies. Emerging clinical trial and real-world data support a broader population of appropriate candidates for JAK inhibition. In psoriasis, newer oral agents, including TYK2 inhibitors, are demonstrating rapid onset of action, with meaningful improvements observed within 4 weeks, challenging prior assumptions about oral therapies. Patient preference is increasingly guiding treatment selection, with comparable acceptance of oral and injectable options. As therapeutic choices expand, clinicians should emphasize appropriate counseling and avoid premature switching, particularly when early response kinetics may vary.¹⁰

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Upadacitinib Hits Optimal Targets

A post hoc analysis of the phase 3 Measure Up 1 and 2 trials demonstrates that achieving stringent treatment targets with upadacitinib in moderate to severe AD is associated with substantially greater improvements in patient-reported outcomes. Patients attaining “optimal” targets (EASI 90 and WP-NRS 0/1) at week 16 experienced superior benefits across quality of life, symptom burden, sleep, pain, and psychological domains compared with those achieving “moderate” targets (EASI 75 and ≥4-point itch reduction) or neither. Higher proportions reported minimal disease impact (DLQI 0/1), improved symptom scores (POEM, ADerm-SS), and reduced sleep disturbance and pain. Psychological outcomes, including anxiety and depression, also improved more markedly in the optimal group. Treatment satisfaction was highest among these patients (82%). These findings support treat-to-target strategies prioritizing near-complete clearance and minimal itch.¹¹

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View all coverage from AAD 2026 here.

References

1. Organon debuts new analysis of VTAMA (tapinarof) cream, 1%, phase 3 pooled data demonstrating early and consistent skin clearance and itch improvement in atopic dermatitis patients down to 2 years of age. News release. Organon. March 27, 2026. Accessed April 23, 2026. https://www.organon.com/news/organon-debuts-new-analysis-of-vtama-tapinarof-cream-1-phase-3-pooled-data-demonstrating-early-and-consistent-skin-clearance-and-itch-improvement-in-atopic-dermatitis-patients-down-to-2-year/
2. AAD 2026: Late-breaking nemolizumab data demonstrate clinically meaningful benefits for children aged 2 to 11 with moderate-to-severe atopic dermatitis. News release. Galderma. Published March 28, 2026. Accessed April 23, 2026. https://www.galderma.com/news/aad-2026-late-breaking-data-atopic-dermatitis
3. Arcutis presents new phase 2 results in infants with atopic dermatitis in late-breaking session today at the 2026 American Academy of Dermatology Annual Meeting. News release. Arcutis Biotherapeutics. March 28, 2026. Accessed April 23, 2026. https://www.arcutis.com/arcutis-presents-new-phase-2-results-in-infants-with-atopic-dermatitis-in-late-breaking-session-today-at-the-2026-american-academy-of-dermatology-annual-meeting/
4. Lebrikizumab delivered long-term disease control for up to four years in patients with moderate-to-severe atopic dermatitis. News release. Almirall. March 27, 2026. Accessed April 23, 2026. https://www.almirall.com/newsroom/news/lebrikizumab-delivered-long-term-disease-control-for-up-to-four-years-in-patients-with-moderate-to-severe-atopic-dermatitis
5. Armstrong A, Rubin C, Jarell A, et al. Real-world effectiveness of 12 months tralokinumab treatment in patients with skin of color and atopic dermatitis: Final data from the prospective, non-interventional, international TRACE study. Poster presented at: 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, CO
6. Pink A, Pezzolo E, Jarell A, et al. Minimal disease activity with 12 months of tralokinumab treatment in adults with atopic dermatitis: Real-world data from the prospective, non-interventional, international TRACE study. Poster presented at: 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, CO
7. Armstrong A, Rodriguez A, Jarell A. Real-world effectiveness of 12 months tralokinumab in 495 adult atopic dermatitis patients with hand and feet involvement: Final data from the prospective, non-interventional, international TRACE study. Poster presented at: 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, CO
8. Yu J. Considerations in allergic contact dermatitis in children. Presented at: 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, CO
9. AAD: new results from Sanofi's amlitelimab phase 3 studies in atopic dermatitis presented in late-breaking research session. News release. Sanofi. March 28, 2026. Accessed April 23, 2026. https://www.sanofi.com/en/media-room/press-releases/2026/2026-03-28-15-00-00-3264184
10. Dasilva DR. JAKpot! therapeutic advantages of JAK inhibitors in dermatology: identifying the right patient. Presented at: 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, CO
11. Kirchhof M, Bunick C, Savage L, et al. Impact of Optimal vs moderate skin and itch treatment targets on patient-reported outcomes in moderate-to-severe atopic dermatitis: insights from Measure Up 1 and 2 Phase 3 studies. Poster presented at: 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, CO