A Head-to-Head Analysis of Conjunctivitis in Atopic Dermatitis Therapies

At the DERM 2025 NP PA CME Conference in Las Vegas, Nevada, James Song, MD, FAAD, Chief Medical Officer at Frontier Dermatology in Mill Creek, Washington, presented a poster examining treatment-emergent conjunctivitis in clinical trials of abrocitinib, a selective JAK1 inhibitor, for atopic dermatitis (AD). The analysis compared conjunctivitis incidence rates between abrocitinib and dupilumab, an IL-4 receptor blocker, using post hoc data from multiple studies, including JADE COMPARE, MONO-1, MONO-2, and JADE TEEN.

Conjunctivitis is a known adverse event of special interest in patients treated with biologics for AD, especially those targeting IL-4/IL-13 pathways. However, conjunctivitis can also occur in AD patients not on systemic therapies, suggesting it may be a disease comorbidity. Song's analysis focused only on conjunctivitis that emerged after treatment initiation, not cases present at baseline.

Findings showed that patients with more severe disease and older age were more prone to treatment-emergent conjunctivitis. Importantly, the data revealed higher conjunctivitis rates with dupilumab compared to abrocitinib, aligning with their known safety profiles. Moreover, abrocitinib did not show increased conjunctivitis rates versus placebo, reinforcing its favorable tolerability in this regard.

Song also highlighted exciting developments in dermatology. While psoriasis treatment has seen major advances—largely with biologics—many patients prefer oral therapies. A new wave of more effective oral treatments is expected soon. In contrast, AD remains more complex and heterogeneous, often requiring combination therapies. Emerging treatments are targeting novel pathways like OX40, IL-31, and IL-22, with a focus on synergistic combinations.

Other promising areas include hidradenitis suppurativa (HS), where JAK inhibitors show potential even in biologic-refractory patients, especially when treated early. For prurigo nodularis, 2 biologics are approved, with more therapies in development. Lastly, in chronic spontaneous urticaria (CSU), dupilumab’s approval is helping dermatologists reclaim management of the condition, alongside new agents like BTK and C-KIT inhibitors on the horizon.