Managing the Topical to Biologic Transition in Clinical Practice

Panelists discuss how decisions regarding biologic monotherapy vs combination with topicals in atopic dermatitis management are individually tailored based on disease severity, distribution, prior topical response, treatment burden, patient preference, and insurance considerations. Most practitioners implement a gradual transition that maintains topicals during biologic initiation, tapering as systemic control improves while still reserving topicals for breakthrough flares, sensitive areas, or maintenance of partially responsive sites, ultimately aiming to minimize steroid exposure while maximizing quality of life and treatment satisfaction.