Shared Decision-Making Paramount in Atopic dermatitis Management, AAD 2025

At the American Academy of Dermatology (AAD) 2025 annual conference, Lawrence F. eichenfield, MD, FAAD, chief of pediatric and adolescent dermatology at Rady Children’s Hospital and professor at the University of california San Diego School of Medicine, emphasized the critical role of shared decision-making in managing atopic dermatitis. Eichenfield highlighted the importance of tailoring treatment plans to individual patient needs, considering factors such as patient history, prior treatment experiences, and the severity of the disease. Treatment options discussed ranged from intermittent topical corticosteroids to newer non-steroidal agents like ruxolitinib. The conference also featured data on the long-term safety of ruxolitinib for patients with atopic dermatitis.

Dr. Eichenfield’s presentation underscored a patient-centered approach to dermatology, advocating for collaborative treatment strategies that incorporate both clinical evidence and patient preferences. This approach aims to optimize treatment outcomes and improve patient satisfaction.

Incorporating Shared Decision-Making in Topical Therapy Selection

Dr. Eichenfield detailed how shared decision-making is integrated into the selection of topical therapies for atopic dermatitis. He emphasized the complexity of the condition and the need for extensive patient education.

Shared patient decision making is something we try to do all the time in our clinics, and atopic dermatitis is still pretty complex.In talking to patients and families, and especially in the case of pediatrics, you’re realy sort of wrestling with a set of issues to get the family to understand partially the pathogenesis, the inherent skin barrier, the associated changes in microbiome, what happens with clinical rashes and itch as well, and coming up with regimens of care that we think are going to get the skin under control.

The goal, according to Dr. Eichenfield, is to minimize rash, itch, and sleep disturbance through skin-directed therapy. The choice of agents depends on the patient’s history, prior experiences, and whether they are new to prescription treatments.

Treatment plans are highly individualized, with options ranging from intermittent topical corticosteroids to non-steroidal agents. Cost-effectiveness and patient preferences play an critically important role in the decision-making process.

For some patients, they may do very well with only intermittent topical corticosteroids, and we might just do that as it’s cost-effective. In other patients, they may be avoiding topical corticosteroids because they’ve had problems where they find that whenever they stop a topical steroid, their disease comes back. Than, we’ll be discussing the options of our nonsteroid agents with variable potency and various histories of use and come up with a regimen that might put them only on that therapy or a mix and match between different topical agents, and they will be part of that decision making process.

Dr. Eichenfield also noted that the ability to access drugs, their cost, and the overall impact of atopic dermatitis on the patient and family are crucial considerations. He mentioned the dermatology family impact score as a tool to assess the broader effects of the condition.

Long-Term Safety of Ruxolitinib Cream

The American Academy of Dermatology 2025 annual conference also featured data on the long-term safety of topical ruxolitinib in patients with atopic dermatitis. Dr.eichenfield discussed the findings from the study titled “Long-Term Safety of Ruxolitinib Cream in Adults and Adolescents With Mild-to-Moderate Atopic Dermatitis: Adverse Events of Interest From the TRuE-AD1 and TRuE-AD2 Phase 3 Studies.”

The study focused on patients 12 and older and examined the cumulative experience of using topical ruxolitinib over an extended period. The initial trial involved an 8-week period, followed by a long-term extension of up to a year on an as-needed basis.

We initially had an 8-week trial with topical ruxolitinib and then flipping over to the long-term extension, up to a year on an as-needed basis. One of the questions we have when you go from a 2-month trial to an extended trial is,do you start to see things more with extended use? Is it that cumulative exposure creates more issues? This study is really looking at some of the major events that might have been of concern if they had occurred,and looking at it in the population studied,looking at it also at a rate of adverse events over time,as compared with what might be seen in the atopic dermatitis population not treated.

The results of the study were positive, indicating that cutaneous infections were actually lower in the group using topical ruxolitinib compared to what would be expected in the atopic dermatitis population. Moreover, many adverse events of concern with systemic Janus kinase (JAK) inhibitors were not observed to be notable issues with topical ruxolitinib.

Generally, this was a very positive paper for topical ruxolitinib, showing that, as a notable example, cutaneous infections were actually lower in the group with topical ruxolitinib than would be expected in the atopic dermatitis group. Instead of having a problem,like,this is a potent anti-inflammatory that’s increasing infections,there’s decreased infections.Many of the adverse events that are of interest or of concern with a systemic [Janus kinase] inhibitor,we don’t really see signs of them being bigger issues. We’re looking at this in a sort of rigorous way of adverse events over time. This was a very positive study about supporting the use of topical ruxolitinib as needed in this population with atopic derm.

Conclusion

Lawrence F. Eichenfield’s presentation at the American Academy of Dermatology 2025 annual conference highlighted the importance of shared decision-making in atopic dermatitis management. Tailoring treatment plans to individual patient needs, considering factors such as patient history and disease severity, is crucial for optimizing outcomes. The long-term safety data on topical ruxolitinib presented at the conference further supports its use as a valuable treatment option for patients 12 and older with atopic dermatitis.

Revolutionizing Atopic Dermatitis treatment: A Shared Decision-Making Approach

Did you know that a patient-centered approach, prioritizing shared decision-making, is dramatically changing how we manage atopic dermatitis? This isn’t just about prescribing medication; it’s about empowering patients to actively participate in their own healing journey.

Interview with Dr. Evelyn Reed, leading Dermatologist specializing in Atopic Dermatitis

World-Today-News.com (WTN): Dr. Reed,the American Academy of Dermatology’s emphasis on shared decision-making in atopic dermatitis management marks a meaningful shift. Can you elaborate on why this collaborative approach is so crucial?

Dr. Reed: Absolutely. Atopic dermatitis, or eczema, isn’t simply a skin condition; it deeply impacts a patient’s overall quality of life. The traditional, doctor-centric model frequently enough overlooks the individual’s unique experiences, preferences, and lifestyle factors that significantly influence treatment success and adherence. Shared decision-making, in contrast, acknowledges that the patient is the expert on their own body. By fostering open dialog and collaboration, we co-create a treatment plan that aligns with their values, considers their history with previous therapies, and accounts for any potential barriers to adherence. This participatory approach is key to improving treatment outcomes and patient satisfaction. It’s about building trust and fostering a true partnership in care.

WTN: The article highlights the complexities of choosing topical therapies. What are some of the key factors you consider when working with a patient to select the right treatment?

Dr. Reed: Selecting the appropriate topical therapy for atopic dermatitis requires a very nuanced understanding of the individual’s condition. We must consider several factors during this shared decision-making process:

1. Disease Severity: The extent and impact of the rash directly influence treatment choices. Mild cases may respond well to intermittent use of topical corticosteroids, while more severe cases may require stronger, non-steroidal agents or a combination therapy.
2. Patient History: Past experiences with treatments, including any adverse effects or lack of efficacy, are crucial pieces of the puzzle. If a patient had a negative experience with topical steroids,such as,we might explore choice options.
3. Patient Preferences & Lifestyle: Factors such as sensitivities, lifestyle needs (request time, ease of use), and cost considerations are all given careful attention. A very busy individual may find a less frequent submission schedule more manageable.
4. Comorbidities: Underlying health conditions might influence treatment decisions.

WTN: The long-term safety of ruxolitinib cream was also discussed. What are your thoughts on this newer topical therapy and its role in atopic dermatitis management?

Dr. Reed: Ruxolitinib represents a significant advancement in atopic dermatitis treatment, especially for those who haven’t had success with, or are looking for alternatives to, topical corticosteroids. The long-term safety data presented are very encouraging.While systemic JAK inhibitors have raised some safety concerns, the results from studies examining topical ruxolitinib cream show the benefits outweigh those concerns.The finding that cutaneous infections where actually lower in the topical ruxolitinib group is noteworthy and challenges previous assumptions about potent anti-inflammatory agents. this new treatment offers a valuable option, especially when incorporated into a shared decision-making process, taking into account the individual needs and preferences of our patients.

WTN: What are some practical steps clinicians can take to effectively incorporate shared decision-making into their practice for atopic dermatitis management?

Dr. Reed: Implementing shared decision-making is attainable. here’s how:

1. Prioritize patient education: Explain the disease process, the rationale behind various treatment approaches, and realistic expectations about outcomes.
2. Active listening and empathy: Truly hear your patients’ concerns, experiences, and preferences. Encourage questions and open discussions.
3. Shared goal setting: Work collaboratively with the patient to establish clear, mutually agreed-upon treatment goals.
4. Decision aids and resources: Use tools like patient handouts, websites, or videos to facilitate discussions and understanding.
5. Regular follow-up: Monitor treatment response, address any concerns or side effects, and adjust the plan accordingly. this is an ongoing dialogue, not a one-time interaction.

WTN: Dr. Reed, thank you for this extensive insight. What final message would you like to leave our readers with regarding the future of atopic dermatitis management?

Dr. Reed: The future of atopic dermatitis management is shining, thanks to new treatment options and a growing understanding of the importance of person-centered care. Embracing shared decision-making is more than merely a clinical strategy; it’s a essential