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

After a new focused update was issued by the American Academy of Dermatology (AAD), adding to the guidelines for topical and systemic atopic dermatitis treatments in adults, Robert Sidbury, MD, MPH, spoke with HCPLive about the update and its relevance to clinicians and patients.1,2

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.2

“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.

References

1. 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.

2. 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. doi: 10.1016/j.jaad.2025.05.1386. Epub ahead of print. PMID: 40531067.