Robert Sidbury, MD, MPH, is the division head of dermatology at Seattle Children's Hospital and a professor of pediatrics at the University of Washington School of Medicine.

Robert Sidbury, MD, MPH

 was issued by the American Academy of Dermatology (AAD), adding to the guidelines for topical and systemic 

 treatments in adults, Robert Sidbury, MD, MPH, spoke with 

 about the update and its relevance to clinicians and patients.

Sidbury is known for his role as a professor in the Department of Pediatrics at the University of Washington School of Medicine and as chief of the Division of Dermatology at Seattle Children’s Hospital. Sidbury’s multidisciplinary workgroup recently conducted a systematic review that resulted in this update by the AAD, with the investigators having implemented the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach for assessing evidence on recently approved drugs.

Significance of AAD Guideline Updates for Atopic Dermatitis, with Robert Sidbury, MD, MPH

“It had a lot to do with just how far down the road the studies [we evaluated] were,” Sidbury explained. “If you look at the National Eczema Association website, it is just a wonderful resource. It’s a patient advocacy group, but it is also a fabulous resource for providers, for journalists, for anyone interested in this space…You can go to a tab on their ‘Research’ page, which lists all of the clinical trials and their various stages of development, phase 1, phase 2, phase 3, and beyond. If you're in phase 3 development, you've passed some significant hurdles, and though it does not mean you'll be granted FDA approval, it is a significant distance down the road to having a drug you can prescribe.”

The decision to include this update, specifically regarding 4 newly US Food and Drug Administration (FDA)-approved treatments for atopic dermatitis, was the result of the level of research supporting each of their uses. The therapies were roflumilast cream 0.15%, tapinarof cream 1%, lebrikizumab, and nemolizumab (with topical therapy), with each being recommended by the AAD for physicians to integrate into clinical practice.

Sidbury noted that this update allows clinicians to have more options for patients who are prone to various side effects. Sidbury used the examples of dupilumab and Janus-Kinase (JAK) inhibitors to describe scenarios in which clinicians may be able to make informed decisions with more alternatives.

“Dupilumab, for instance, and other IL-13 category blockers, can have conjunctivitis or irritation of the eyes that is non-infectious. It's an inflammatory conjunctivitis,” Sidbury said. “But if that patient before you, and you're talking about various options, has a really bad history of conjunctivitis or other ocular disease, not an absolute contraindication to those medications…you'd want to review all of the options with that patient before choosing that one. Similarly, the JAK-inhibitors, another class of medication that is newer, have a boxed warning with various conditions and concerns that may always be important to discuss with patients, but may, given that particular patient's history and comorbidities, make that class of medications either a good choice or not.”

To find out more about the AAD’s atopic dermatitis guideline changes, view the full interview video posted above.

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

Sidbury has reported serving on Pfizer’s advisory board, for which he receives honoraria; acting as an investigator for Brickell Biotech and Galderma USA, with support through grants and research funding; serving as a principal investigator for Regeneron, also receiving grant and research support; and working as a consultant for Galderma Global and Microes, with compensation provided or, in some cases, not received.

Smith T. 4 New Recommendations for Atopic Dermatitis Management, with Robert Sidbury, MD, MPH. HCPLive. July 3, 2025. Accessed July 7, 2025. 

https://www.hcplive.com/view/4-new-recommendations-atopic-dermatitis-management-robert-sidbury-md-mph

Davis DMR, Frazer-Green L, Sidbury R, et al. Focused update: Guidelines of care for the management of atopic dermatitis in adults. J Am Acad Dermatol. 2025 Jun 17:S0190-9622(25)02125-5. 

Videos

Following the AAD guideline update on atopic dermatitis treatments, Sidbury speaks to the significance of the guideline recommendations for patients and clinicians.

A new focused update has been issued by the American Academy of Dermatology (AAD) regarding guidelines on the utilization of topical and systemic drugs for adults with 

, given the recent emergence of several novel therapies.

A multidisciplinary workgroup recently conducted a systematic review that led to this update, applying the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to available evidence. Robert Sidbury, MD, MPH, a professor in the Department of Pediatrics at the University of Washington School of Medicine and a chief of the Division of Dermatology at Seattle Children’s Hospital, spoke with 

4 New Recommendations for Atopic Dermatitis Management, with Robert Sidbury, MD, MPH

“The fact that this exists is an evolution,” Sidbury said. “I've been part of the AAD [atopic dermatitis] guidelines since 2004, then again in 2014, and the field has just changed so rapidly. We've had so many new medications, which is exciting, but it means that it’s a guideline out every 5 to 10 years that can quickly become out of date…The AAD had the foresight to plan for that this go round and have us review the evidence for medications which were not yet approved by the time we had planned to publish the manuscript with regard to topical therapies and systemic therapies.”

The 4 treatments highlighted in the focused update were tapinarof cream 1%, lebrikizumab, roflumilast cream 0.15%, and nemolizumab (with topical therapy). These treatments are recommended for clinicians to integrate into clinical practice.

 in 2024 for moderate to severe atopic dermatitis. The nonsteroidal aryl hydrocarbon receptor agonist demonstrated significant clinical improvements in Investigator’s Global Assessment (IGA), Eczema Area and Severity Index (EASI)-75, and itch scores following once-per-day use for 8–12 weeks in 4 trials. Lebrikizumab, an interleukin (IL)-13 monoclonal antibody, was approved in 2024 for moderate to severe disease, having shown improved clinical and patient-reported outcomes in over 1,700 individuals, with or without topical corticosteroids.

Roflumilast cream 0.15%, a topical PDE4 inhibitor approved in 2024 for mild to moderate disease, had shown significant gains in IGA and EASI-75 within trials featuring 1,427 patients and 4 weeks of treatment. Nemolizumab (plus topical therapy) was approved in 2024 for patients 12+ with inadequately controlled atopic dermatitis, and it led to notable itch reductions as well as improvements in Dermatology Life Quality Index (DLQI) and EASI-75 across 3 studies when paired with topical corticosteroids (± topical calcineurin inhibitor).

“Our work group used the same GRADE format, which is just a systematic way of evaluating evidence that we've used for all of the manuscripts this go-round,” Sidbury explained. “We reviewed the literature of these medications that we're going to talk about today and sort of put it aside and said, ‘Once they're FDA-approved, then we'll be able to publish a focused update with the recommendations for these medications.’”

For any additional information about the atopic dermatitis guideline recommendations, view the full interview segment posted above.

The quotes contained in this summary were edited for clarity.

Sidbury reports serving on Pfizer’s advisory board, for which he receives honoraria; acting as an investigator for Brickell Biotech and Galderma USA, with support through grants and research funding; serving as a principal investigator for Regeneron, also receiving grant and research support; and working as a consultant for Galderma Global and Microes, with compensation provided or, in some cases, not received.

Sidbury highlights updates to previous guidelines on the management of atopic dermatitis using approved topical and systemic therapies.

Robert Sidbury, MD, MPH

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