Individualizing Biologic Therapy for Atopic Dermatitis

Prior to his session presented at the 2026 Fall Clinical Dermatology Conference, Raj Chovatiya, MD, PhD, emphasized that selecting biologic therapy for moderate-to-severe atopic dermatitis (AD) requires a holistic approach that considers efficacy, safety, disease characteristics, and patient preferences rather than relying on a single factor.

After determining that systemic therapy is appropriate, Dr Chovatiya considers the patient’s age, affected body areas, treatment approach, and available clinical evidence. Injection frequency, expectations for long-term treatment, and the potential to withdraw therapy can also influence selection. Although biomarkers may eventually help match patients with specific therapies, current decisions remain largely driven by clinical factors.

Treatment goals can also vary substantially among patients. Some prioritize achieving clear skin, while others are primarily concerned with rapid and sustained itch relief. For others, reducing treatment burden or eventually discontinuing therapy may be most important. Dr Chovatiya encouraged clinicians to ask patients directly about their priorities and combine those preferences with their own clinical goals when selecting and monitoring treatment.

For patients with an inadequate response to a biologic, Dr Chovatiya cautioned against switching therapies too quickly. He generally aims for 4 to 6 months of treatment, optimizing therapy with topical treatments or other approaches when appropriate, before determining whether treatment goals have been achieved.

If a change is needed, differences in biologic mechanisms can help guide the next choice. Dr Chovatiya noted that available data indicate patients may still achieve a response after switching biologics, even between therapies with overlapping mechanisms.

He also encouraged clinicians to consider available real-world and clinical trial evidence when making switching decisions. Ultimately, Dr Chovatiya emphasized returning to the same shared decision-making process used when initiating therapy: evaluating the evidence, discussing treatment characteristics, identifying the patient’s priorities, and selecting the next treatment together.

Full video coming soon.

Reference
Chovatiya R. Better biologic decision-making for moderate-to-severe atopic dermatitis: an interactive expert exchange. Presented at: Fall Clinical Dermatology Conference; October 8–11, 2026; Las Vegas, NV.