J Am Acad Dermatol

AAD guideline update adds four high-evidence therapies for adult atopic dermatitis

August 1, 2025

In its 2025 focused update, the American Academy of Dermatology (AAD) expands its adult atopic dermatitis (AD) recommendations to include four newly approved therapies. These additions reflect high-certainty evidence and strong recommendations, supplementing the 2023–2024 guidance with novel topical and systemic options.

• Tapinarof cream 1% recommended for adults with moderate to severe AD. This nonsteroidal topical agent showed significant improvements in disease severity and pruritus over 8–12 weeks in phase 2 and 3 trials, with a favorable safety profile and low discontinuation rates.
• Roflumilast cream 0.15% recommended for adults with mild to moderate AD. In multiple trials, once-daily application for 4 weeks led to significant improvements in validated AD severity and itch scores, with minimal adverse effects and good tolerability.
• Lebrikizumab recommended for adults with moderate to severe AD. This IL-13–targeting biologic demonstrated large improvements in disease severity, itch, and quality of life across monotherapy and combination trials, with low rates of adverse events and discontinuation.
• Nemolizumab with concomitant topical therapy recommended for adults with moderate to severe AD inadequately controlled by topicals. Targeting the IL-31 receptor, nemolizumab significantly improved itch and disease severity over 16–24 weeks, with a favorable safety profile when used alongside corticosteroids and/or calcineurin inhibitors.

Source:

Davis DMR, et al. (2025, June 17). J Am Acad Dermatol. Focused update: Guidelines of care for the management of atopic dermatitis in adults. https://pubmed.ncbi.nlm.nih.gov/40531067/