Day 2 Recap: Fall Clinical 2026

The second day of the 2026 Fall Clinical Dermatology Conference in Las Vegas focused on psoriasis and atopic dermatitis (AD), with new data on combination therapy and long-term durability. Investigators presented exploratory biomarker findings for ixekizumab plus tirzepatide in patients with psoriasis and obesity, and 2-year skin clearance results for the oral IL-23 receptor blocker icotrokinra. In AD, Galderma announced 3-year nemolizumab data, a post hoc analysis addressed flare concerns when switching from dupilumab to upadacitinib, and Raj Chovatiya, MD, PhD, MSCI, shared advice on choosing among biologics.

Ixekizumab Plus Tirzepatide Shifts Biomarkers in Psoriasis with Obesity

An exploratory, prespecified analysis of the phase 3b TOGETHER-PsO trial found that ixekizumab (Taltz) plus tirzepatide (Zepbound) produced broader biomarker changes than ixekizumab alone in adults with moderate to severe plaque psoriasis and obesity or overweight. By week 36, combination therapy altered 482 proteins and 467 genes, compared with 140 proteins and 16 genes with ixekizumab alone, and broader responses appeared as early as week 12. Changes in a subset of neutrophil-associated markers mediated part of the additional PASI response seen with the combination. The 52-week trial randomized 274 adults 1:1. Topline results showed 27.1% of patients on the combination reached both PASI 100 and weight loss of 10% or more at week 36, vs 5.8% with ixekizumab alone (P < .001). Adverse events were generally mild to moderate and consistent with each agent’s known profile, and Lilly plans to publish the detailed 36-week results in a peer-reviewed journal.

Icotrokinra Maintains Skin Clearance Through 2 Years in Phase 3 ICONIC-LEAD

In a poster from the phase 3 ICONIC-LEAD trial, at least 72% of patients with moderate to severe plaque psoriasis treated with icotrokinra (Icotyde) held PASI 90 from week 64 through week 112. At least 70% maintained an IGA score of 0/1 over the same period. At least 44% held PASI 100, and itch improvement was sustained in 78% of patients. Among PASI 90 responders withdrawn from treatment at week 24, 85% regained PASI 90 within 24 weeks of retreatment. No new safety signals emerged through week 112. Two-year ICONIC-TOTAL data in high-impact sites, presented at EADV last week, showed continued scalp, genital, hand and foot, and nail improvement. Icotrokinra is a once-daily oral peptide that blocks the IL-23 receptor, and the FDA approved it in March 2026.

Nemolizumab Maintains Deep Skin and Itch Responses Through 3 Years in Atopic Dermatitis

Galderma announced 3-year data ahead of the conference from a post hoc analysis of the ARCADIA long-term extension study. Among patients with moderate-to-severe AD who responded by week 16, responses were largely maintained through week 152. At 3 years, 80% achieved EASI 90 and 80% reached an itch-free or nearly itch-free state, while 76% had clear or almost-clear skin and 50% had complete clearance. A separate prespecified interim analysis of the broader LTE population showed sustained improvements in skin, itch, sleep, and quality of life, with no new safety signals. Nemolizumab (Nemluvio) targets the IL-31 receptor alpha. Phase 2 pediatric data in children aged 2 to 11 years also showed responses sustained through week 52.

Choosing a Biologic in Atopic Dermatitis

In an interview with Dermatology Times, Raj Chovatiya, MD, PhD, MSCI, offered 2 key takeaways for clinicians. First, for a systemic therapy-ready patient with AD, the priority is getting them on a systemic therapy, and in his view there are no wrong answers as long as that happens. Helping a patient get past remaining uncontrolled on topicals is, he said, a win. Second, he urged clinicians to understand the data behind current biologics, particularly dupilumab, tralokinumab, and lebrikizumab, which can all block IL-13. He pointed to differences in trial designs, patient populations, outcomes of interest, and safety, and said the goal is to translate that data into real-world choices that equip clinicians and patients to decide together.

No Observed Skin Lesion Flares After Switching to Upadacitinib in Atopic Dermatitis

A post hoc analysis of the LEVEL UP and HEADS UP trials found no skin lesion flares through 16 weeks in patients with moderate to severe AD who switched to upadacitinib (Rinvoq) after an inadequate response to dupilumab (Dupixent). No flares occurred in LEVEL UP (0/201) or HEADS UP (0/27). Itch flares were infrequent, occurring in 3.6% (5/139) of eligible patients in LEVEL UP and 4.8% (1/21) in HEADS UP, among those with baseline WP-NRS scores of 6 or lower. The analysis included 207 patients from LEVEL UP and 28 from HEADS UP. The poster did not report safety data for the switch population. The authors noted the findings may help inform switch discussions with patients worried about worsening disease. The analysis was post hoc, and the HEADS UP cohort was small.

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