Shared Decisions, Better Outcomes in Atopic Dermatitis, With Weily Soong, MD

Atopic dermatitis management has evolved rapidly in recent years, and allergists are playing a central role in that transformation. What was once a treatment landscape dominated by topical and systemic steroids has transformed into one defined by precision-targeted options, including biologics, JAK inhibitors, and next-generation non-steroidal topicals. Several recent FDA approvals have accelerated this shift. Nemolizumab (Nemluvio), an IL-31 receptor–blocking biologic, received approval in December 2024 for patients aged 12 and older.1 That same month, tapinarof cream 1% (VTAMA), a once-daily, non-steroidal aryl hydrocarbon receptor agonist, was approved for children as young as 2 years old.2 Most recently, in October 2025, the FDA expanded the indication for roflumilast cream 0.05% (Zoryve) to include children ages 2 to 5, introducing another long-acting, steroid-free option for young patients.3

At a recent clinical forum convened by HCPLive in Orlangdo, Florida, dermatologists and allergists led by Weily Soong, MD, Associate Professor, University of Alabama at Birmingham and Chief Medical Officer for AllerVie Clinical Research, gathered to explore how these developments are transforming real-world care for children with atopic dermatitis and the evolving collaborations of allergists and dermatologists.

HCPLive caught up with Soong to learn more about some of the hot topics discussed during the forum. He noted that allergists routinely care for people with atopic dermatitis because it is the starting point of the atopic march and one of the strongest risk factors for asthma, allergic rhinitis, and food allergies. As a result, allergists regularly evaluate AD within the broader context of multisystem allergic disease, often seeing children and adults whose conditions require a long-term chronic disease framework.

Shared decision-making plays a central role in Soong’s practice, whether selecting between faster-acting agents like ruxolitinib or longer-term disease controllers such as tapinarof. He emphasized that itch, sleep disruption, and caregiver burden carry significant weight in treatment planning—reflecting atopic dermatitis's profound psychological and emotional toll.

Despite advances, access remains a critical barrier. Insurance payers continue to default to low-cost topical steroids, leaving many families struggling to obtain safer, more effective non-steroidal therapies. Soong advocated for improved coverage policies and hopes growing clinical evidence will help shift first-line standards toward modern, steroid-free treatments that meaningfully reduce the burden of atopic dermatitis for patients and families.

"Newer creams have much better efficacy, [a] much better safety profile than than topical steroids. Hopefully one day, they will become the first line treatment instead of topical steroids... [I hope] one day we can improve access, because we really could relieve the burden of atopic dermatitis on patients, if all these newer creams [were] better covered," Soong said.

References

1. Galderma Receives U.S. FDA Approval for Nemluvio® (Nemolizumab) for Patients with Moderate-to-Severe Atopic Dermatitis. News release. Galderma. December 13, 2024. https://investors.galderma.com/news-releases/news-release-details/galderma-receives-us-fda-approval-nemluvior-nemolizumab-patients

2. FDA Approves VTAMA® (tapinarof) cream, 1% for the Treatment of Atopic Dermatitis in Adults and Children 2 Years of Age and Older. News release. Organon. January 3, 2025. https://nationaleczema.org/blog/press-release-vtama-tapinarof-cream-atopic-dermatitis/?utm_source=chatgpt.com

3. FDA Approves Arcutis’ ZORYVE® (roflumilast) Cream 0.05% for the Treatment of Atopic Dermatitis in Children Ages 2 to 5. News release. Arcutus. October 6, 2025. https://investors.arcutis.com/news-releases/news-release-details/fda-approves-arcutis-zoryver-roflumilast-cream-005-treatment?utm_source=chatgpt.com