What to Expect for Sleep Improvement With Tapinarof in AD, With Druhan Howell, MD

Counseling families about treatment timelines in pediatric atopic dermatitis (AD) often centers on when meaningful itch relief can be expected, but emerging data on tapinarof cream now allows clinicians to incorporate anticipatory guidance around sleep improvement into those early discussions as well.1,2

At the 2026 American Academy of Allergy, Asthma & Immunology (AAAAI) annual meeting in Philadelphia from February 27 - March 2, HCPLive spoke with Druhan Howell, MD, an allergist from Mobile, Alabama, on a recent pooled analysis of ADORING 1 and ADORING 2 examining sleep outcomes of once-daily tapinarof for 8 weeks in pediatric patients with moderate to severe AD. The analysis showed that once daily tapinarof cream 1% (VTAMA), an US Food & Drug Administration (FDA)-approved nonsteroidal topical aryl hydrocarbon receptor agonist for AD, was associated with early and sustained improvements in sleep-related outcomes in children aged 2 – 17 years.

Investigators observed sleep improvements as early as 1 week. By week 8, children treated with tapinarof demonstrated greater mean improvements in POEM and DFI scores compared with those who received vehicle. This was observed across age groups 2 – 6 years (P <.0001 and P =.0002, respectively), 7 – 11 years (P =.0029 and P =.0049), and 12 – 17 years (P <.0001 and P =.0283).

For Howell, this alignment between itch reduction and sleep improvement provides a practical framework for expectation-setting. Families frequently present after prolonged periods of nocturnal scratching and fragmented sleep. Being able to counsel that both itch and sleep may begin to improve within the first week offers a tangible and time-bound treatment goal. She emphasized that sustained improvement through 8 weeks, along with a safety and tolerability profile consistent with earlier analyses, supports incorporating sleep into routine counseling.

Howell said the findings match up to what she sees in clinical practice, with tapinarof cream improving sleep.

“I've had patients who we are seeing, and they come back, and we're talking about how nice it is now that the kids are not up all night, scratching and itching, waking parents up, waking other siblings up that they share bedrooms with,” Howell said. “Those discussions [of sleep improvement] were already happening on the side in my clinic, but now I have some meaningful data that is representative of that clinical impact that I was already seeing.”

Reported disclosures for Howell include Organon, Dermavant Sciences, Inc., AstraZeneca Pharmaceuticals LP, Actelion Pharmaceuticals US, Inc., GENZYME CORPORATION, Regeneron Healthcare Solutions, Inc., CSL Behring, Takeda Pharmaceuticals U.S.A., Inc., Blueprint Medicines Corporation, Amgen Inc., Philips North America LLC, Pulmonx Corporation, Boehringer Ingelheim Pharmaceuticals, Inc., Merck Sharp & Dohme LLC, Grifols USA, LLC, Baxter Healthcare, Vifor Pharma, Inc., Mylan Specialty L.P., and more.

References

1. Boguniewicz M, Eichenfield LF, Kwong P, Hebert A. Improvement in sleep and family impact for pediatric patients down to 2 years of age with atopic dermatitis treated with tapinarof cream 1% once daily in two pivotal phase 3 trials. J Allergy Clin Immunol. 2026;157(2). https://www.jacionline.org/article/S0091-6749(25)XXXX-X/fulltext

2. Howell D. Tapinarof Cream 1% Improves Sleep in Atopic Dermatitis, With Druhan Howell, MD. HCPLive. Published on February 27, 2026. Accessed on February 27, 2026. https://www.hcplive.com/view/tapinarof-cream-1-improves-sleep-atopic-dermatitis-druhan-howell-md