Raj Chovatiya, MD, PhD

OX40/OX40L Target Shows Promise for Atopic Diseases I Raj Chovatiya, MD, PhD Insights at ACAAI 2025

, Raj Chovatiya, MD, PhD, from Northwestern Feinberg School of Medicine, said that the OX40/ OX40L target shows promise as a first-line treatment for conditions such as 

atopic dermatitis, asthma, and chronic urticaria 

“I think that these therapies definitely are going to be the right first-time choice for some patients, for others that might feel that they want to get a little more experience; they might be used after other systemic therapies,” Chovatiya said. “The nice thing is that we have data for both of these populations, and so I look forward to seeing some more of those sub-analyses to really help us understand what it means to be truly naive, or treatment-experienced and be treated with drugs like rocatinlimab and amlitelimab.”

Chovatiya will present the OX40/OX40 ligand target at the 

2025 American College of Allergy, Asthma, & Immunology (ACAAI) Annual Scientific Meeting 

in Orlando, Florida, on Saturday, November 8, during the session, “7 for 11: Hot Therapeutic Targets in Allergy and Immunology.”

 spoke with Chovatiya about what we know to date about the OX40/OX40 ligand pathway from clinical trials and how OX-40-targeted therapies fit into existing treatment. He talked about 2 treatments under investigation: rocatinlimab, an antibody that binds to the OX40 receptor on T cells, and amlitelimab, an antibody that binds to the OX40 ligand on activated antigen-presenting cells.

Although rocatinlimab and amlitelimab show promise in atopic diseases, Chovatiya noted one major challenge, which is the lack of real-world data.

“These are very different drugs [from the] ones we've had before,” he said. “It's not like we're seeing yet another blocker of the IL-13 pathway, so we have an idea what to expect clinically. I think there's going to be a lot of challenges and growing pains, like with any new therapeutic class when it's introduced into the real world.”

Chovatiya looks forward to hearing his colleagues’ experiences with integrating these OX40-targeting therapies into real-world practice. He said he is curious to see how it will fall into the treatment paradigm, whether it will be used as a monotherapy or combination therapy, the timing of when patients will experience improvement, and the long-term advantages of these therapies over therapies with other targets.

“I want people to get excited, because at the end of the day, excitement is what drives more innovation,” Chovatiya said. “Understanding that we need more drugs for atopic dermatitis and every drug is going to have a slightly different home and a different scenario… really allows us to have a number of distinct therapies that coexist. You really have to be into the science…and you have to try [these drugs] …and figure out the right patients. By virtue of all of us being able to stay on top of the data and clinical use, we're going to really be able to create a picture of exactly finding the right treatment for the right patient.”

Relevant disclosures for Chovatiya include AbbVie, Amgen, Apogee Therapeutics, Arcutis, Argenx, ASLAN Pharmaceuticals, Beiersdorf, Boehringer Ingelheim, Bristol Myers Squibb, Cara Therapeutics, Dermavant, Eli Lilly and Company, FIDE, Formation Bio, Galderma, Genentech, GSK, Incyte, LEO Pharma, L’Oréal, Nektar Therapeutics, Novartis, Opsidio, Pfizer Inc., Regeneron, RAPT, Sanofi, Sitryx, and UCB.

Chovatiya R. 7 for 11: Hot Therapeutic Targets in Allergy and Immunology (OX40/OX40L). Presented at 

Amgen And Kyowa Kirin Announce Top-Line Results from Rocatinlimab Phase 3 Ascend Long-Term Extension Study in Adults With Moderate To Severe Atopic Dermatitis. Amgen. Amgen. Published 2020. 

https://www.amgen.com/newsroom/press-releases/2025/09/amgen-and-kyowa-kirin-announce-top-line-results-from-rocatinlimab-phase-3-ascend-long-term-extension-study-in-adults-with-moderate-to-severe-atopic-dermatitis

Press Release: Sanofi’s amlitelimab met all primary and key secondary endpoints in the COAST 1 phase 3 study in adults and adolescents with atopic dermatitis. Sanofi.com. Published 2025. 

https://www.sanofi.com/en/media-room/press-releases/2025/2025-09-04-05-00-00-3144170

Videos

Ahead of ACAAI 2025, HCPLive spoke with Chovatiya on challenges in translating these promising immunologic targets into real-world clinical practice.

Next Step for OX40/OX40L: Real-World Data in Atopic Dermatitis, With Raj Chovatiya, MD, PhD

OX40/OX40 Ligand Target Offers Broader Acting Therapy for Atopic Dermatitis, With Raj Chovatiya, MD, PhD

American College of Allergy, Asthma, & Immunology (ACAAI) 

 spoke with Raj Chovatiya, MD, PhD, from Northwestern Feinberg School of Medicine, on his upcoming presentation, “7 for 11: Hot Therapeutic Targets in 

 He will specifically present on OX40/OX40L, otherwise known as the interaction between the costimulatory TNF receptor OX40 and its ligand, OX40L, and its role in atopic diseases.

“In atopic dermatitis, we've largely had therapies that target downstream elements of inflammation, so this includes cytokines like IL-4 and IL-13, IL-31 and intracellular signaling pathways like the JAK stat pathway, but a challenge has always been that atopic dermatitis is a fairly immunologic heterogeneous disease, meaning that there isn't simply a single cytokine or 2 cytokines that are responsible for the majority of the disease state,” Chovatiya said. “Simply targeting 1 or 2 cytokines may not be enough.”

He continued that OX40 and OX40 ligand activate various types of T-cells. By inhibiting the interaction, it may be possible to stop at the source of the production of T-cells that are driving the disease.

“In many ways, it's a broader acting therapy, but a specifically broader acting therapy that really tends to target this whole compartment of T-cell mediated inflammation,” Chovatiya continued.

Phase 2 and 3 trials have studied this OX40/OX40 ligand target. Therapies investigated include rocatinlimab, an antibody that binds to the OX40 receptor on T cells, and amlitelimab, an antibody that binds to the OX40 ligand on activated antigen-presenting cells. 

“One of the most compelling data we had from earlier phase studies for both of these molecules were that, in addition to patients being able to achieve clinically relevant improvement in the signs and symptoms of their disease, there seemed to be fairly long lasting efficacy, in the sense that patients seem to be able to achieve relatively stable responses even when they are withdrawn from therapy,” Chovatiya said. “The logic here was that perhaps these drugs were in some way modifying elements of the disease at an immunologic level…this has always been one of the holy grails for disease states like atopic dermatitis…. We’ve now been paying very close attention to some of the initial phase 3 readouts to see if this is really going to hold up in a larger-scale clinical trial. Thus far, what we found is that the OX40 and OX40 ligand targeting molecules work.”

Chovatiya R. 7 for 11: Hot Therapeutic Targets in Allergy and Immunology (OX40/OX40L). Presented at ACAAI 2025 in Orlando

Curti BD, Kovacsovics-Bankowski M, Morris N, et al. OX40 is a potent immune-stimulating target in late-stage cancer patients. 

Articles

Raj Chovatiya, MD, PhD, from Northwestern Feinberg School of Medicine, presented on the OX40/OX40L interaction at the 2025 ACAAI Annual Scientific Meeting. This interaction plays a crucial role in atopic diseases by activating T-cells. Targeting OX40/OX40L could offer a broader therapeutic approach for atopic dermatitis, which is immunologically heterogeneous. Phase 2 and 3 trials of rocatinlimab and amlitelimab have shown promising results, with long-lasting efficacy even after therapy withdrawal. These findings suggest potential disease modification at an immunologic level, a significant advancement in treating atopic dermatitis.

At ACAAI 2025, HCPLive spoke with Chovatiya on the OX40/OX40L pathway and what makes it an attractive therapeutic target over other established pathways.

2025 Fall Clinical Dermatology Conference

 in Las Vegas, Nevada, Raj Chovatiya, MD, PhD, co-presented a session titled ‘Seminar-in-Depth: Shifting the Management Paradigm in Generalized Pustular Psoriasis.’

Chovatiya, who currently serves as both clinical associate professor at Rosalind Franklin University Chicago Medical School and director of the Center for Medical Dermatology and Immunology Research, spoke with the team at 

 on his portion of this session. Chovatiya highlighted several key points about managing generalized pustular psoriasis (GPP).

Tips on Addressing Generalized Pustular Psoriasis, With Raj Chovatiya, MD, PhD

“Generalized pustular psoriasis is a pretty rare disease in the dermatology space,” Chovatiya explained. “It's not something that you're going to see perhaps that often in your career, but when you do, it can really be a emergency, from dermatologic perspective. We don't have that many dermatologic conditions where I truly use that word emergency.”

Among patients with GPP, Chovatiya noted, there is a major burden in terms of uncertainty about the course of this skin disease as well as potential for the inpatient hospitalization route, the emergency care route, and even mortality. Chovatiya noted that it is important to know how to diagnose GPP.

“You don't have to have chronic plaque psoriasis to have generalized pustular psoriasis,” Chovatiya said. “It really is a diagnosis that you can make clinically based on the presence of innumerable pustular lesions, usually on an erythematous base on the skin. Typically, there's an onset of symptoms that's highly rapid. There's often a lot of pain…or discomfort that patients experience. And systemic symptoms are another thing that oftentimes accompany this disease, in terms of fever, myalgia, and chills that you just don't see with chronic plaque psoriasis.”

Chovatiya later highlighted GPP’s more homogenous pathway of immunology than had once been thought.

“A lot of the disease itself is mediated by IL-36 and neutrophilic inflammation that is related to IL-36,” Chovatiya said. “it's a very cool story in medicine, how we discovered this as really, once upon a time, it was actually cohorts of consanguineous patients that had similar mutations in this pathway that had a phenotype that we now call GPP. So that's where part three of the talk comes in…where we learned that, actually, blockade of IL-36 signaling can make a huge difference in patients.”

For any additional information on Chovatiya’s talk held at the Fall Clinical Conference, view more by watching his video posted above.

Chovatiya previously reported serving as an advisor, consultant, speaker, and/or investigator for AbbVie, Amgen, Apogee Therapeutics, Arcutis, Argenx, ASLAN Pharmaceuticals, Beiersdorf, Boehringer Ingelheim, Bristol Myers Squibb, Cara Therapeutics, Dermavant, Eli Lilly and Company, FIDE, Formation Bio, Galderma, Genentech, GSK, Incyte, LEO Pharma, L’Oréal, Nektar Therapeutics, Novartis, Opsidio, Pfizer Inc., Regeneron, RAPT, Sanofi, Sitryx, and UCB.

Chovatiya R, Elewski B. Seminar-in-Depth: Shifting the Management Paradigm in Generalized Pustular Psoriasis. Session presentation at the 2025 Fall Clinical Dermatology Conference, Las Vegas, Nevada, Oct 23-26, 2025.

Hawkes JE, Visvanathan S, Krueger JG. The role of the interleukin-36 axis in generalized pustular psoriasis: a review of the mechanism of action of spesolimab. Front Immunol. 2023 Nov 21;14:1292941. 

In his Fall Clinical interview, Chovatiya highlights several key takeaways from his talk on generalized pustular psoriasis (GPP) management.

2025 European Academy of Dermatology and Venereology (EADV) Congress

 in Paris, a poster was presented titled ‘The Physical and Emotional Burden of Prurigo Nodularis in Adult Patients: Impact of Dupilumab on Itch, Pain, and Skin-Related Distress in PRIME 1/2.’

These data on dupilumab (Dupixent) from the PRIME and PRIME2 studies were discussed in a recent interview with Raj Chovatiya, MD, PhD, clinical associate professor at Rosalind Franklin University Chicago Medical School, and director of the Center for Medical Dermatology and Immunology Research. Chovatiya was asked about the significance of these poster data for prurigo nodularis.

Highlighting PRIME Study Findings on Dupilumab for Prurigo Nodularis, With Raj Chovatiya, MD, PhD

“This study was an analysis of previously presented phase 3 data that specifically looked at tupilimab in patients with prurigo nodularis,” Chovatiya explained. “...And the question we really had with this particular analysis was, [given that] we've seen clinical data to really take a look at how well dupilumab performs on some of the clinician-assessed signs of the disease itself, what about the patient perspective?”

Chovatiya was asked during the interview about unmet needs remaining for patients living with the burden associated with prurigo nodularis, a condition characterized by intensely pruritic, fibrotic nodular lesions.

“Our patients would say one of their most important things is they want relief of symptoms, and itch is obviously a key and core symptom for patients,” Chovatiya said. “It's highly intense. But that doesn't mean that itch is the only symptom. Many of our patients experience a high burden of skin pain, stinging, numbing, tingling, and essentially situations where their skin is not where it should be. That is very highly intertwined with the inflammatory lesions. So I think people oftentimes forget that this is not a disease of just itch, and it's not a disease of just bumps or ulcerations or erosions, but rather of both of these together.”

Chovatiya was later asked about what he felt were the most important findings on dupilumab highlighted in his team’s poster data at EADV.

“Sure enough, following dupilumab treatment, over the course of several months, individuals had highly substantial numerical improvements in terms of the proportions of them able to achieve basically complete control, or near complete control, in each of these different parameters,” Chovatiya said. “So the bottom line findings here are that we know that dupilumab works simply based on its approval and phase 3 data. But this is really nice information that we can combine with that to tell our patients that…many of the issues related to how you lead your life as a result of the disease are going to improve alongside the signs and symptoms of the disease itself.”

For any additional information on this poster data, view the full interview posted above.

The quotes contained in this interview summary were edited for the purposes of clarity.

Ständer S, Chovatiya R, Wiggins S, et al. The Physical and Emotional Burden of Prurigo Nodularis in Adult Patients: Impact of Dupilumab on Itch, Pain, and Skin-Related Distress in PRIME 1/2. Presented at the European Academy of Dermatology and Venereology (EADV) 2025 Congress. Paris, France. September 17-20, 2025.

Kwatra SG, Pereira MP, Wiggins S, et al. Prurigo nodularis: disease burden, clinical features and approach to management. Br J Dermatol. 2025 Sep 18;193(4):642-652. 

This interview from EADV highlights recent data from PRIME and PRIME2 on the effects of dupilumab (Dupixent) on itch and pain in prurigo nodularis.