Q&A: What Are the Most Exciting New Atopic Dermatitis Developments? With Mona Shahriari, MD

During the Revolutionizing Atopic Dermatitis (RAD) Conference in Nashville, HCPLive spoke in an interview with Mona Shahriari, MD, associate clinical professor of dermatology at Yale School of Medicine and associate director of clinical trials at Central Connecticut Dermatology Research, who discussed several emerging themes shaping the future of atopic dermatitis management.

Shahriari, also known for her role as host of HCPLive podcast The Medical Sisterhood, touched on the therapeutic landscape’s expansion, highlighting a variety of developments that may further transform treatment strategies. She further emphasized the importance of helping patients navigate an increasingly complex array of options. Outside of novel therapies, Shahriari also noted the practical realities of managing chronic inflammatory disease in everyday practice.

This discussion with HCPLive followed her RAD presentation, which she also highlighted during the interview.¹ The following transcription covers Shahriari’s responses to inquiries about these topics:

HCPLive: There is so much going on today in the atopic dermatitis treatment landscape. What recent developments are most exciting to you?

Shahriari: I think one of the biggest revelations in the treatment landscape is the [news about] OX40-targeting drugs. Up until now, a lot of our drugs had been suppressing inflammation, but the OX40 pathway gives us the potential for a drug that can maybe retrain and even rebalance your immune system and give you the potential for disease modification. They are not by far the fastest drugs in the world, but for them it's more of a marathon and not a sprint.

Obviously, we're going to be watching their safety closely because of some of the signals that we've seen in phase three trials thus far, but I think just targeting the pathway a little bit differently, above the level of the cytokines, above the level of the T-cells that make those cytokines, and really going into that inflammatory prequel really has the potential to give us a different level of skin clearance.

HCPLive: Counseling patients with atopic dermatitis is necessary in dermatology. What are some key ways for clinicians to counsel patients with the inflammatory skin disease?

Shahriari: I feel like prevention is the best thing to do. I counsel them from day one, so that we can avoid the impatience coming down the road. I kind of feel for my AD patients. People think these patients will put up with a lot because they've had their disease for so long. I actually think the contrary; we promised them the world as a specialty and we failed miserably. So, when a treatment is not working, they're very quick to think, ‘This is just like all the other treatments that I've gotten. Why should I stick with it?’

At the get-go, I tell them, ‘All right, this is the realistic expectation of what you can expect in four weeks, eight weeks, sixteen weeks. How long are we going to give this drug to work?’ I check in with them periodically. My first touch point is always at the four-week mark, no matter what drug I start them on. That's partly to kind of see what the insurance piece has been, and make sure they continue on the regimen, but also to keep that touch point and make sure I can reassure them and help them move in the right direction. One thing, especially for patients with skin of color, is when they see the AD fade, the dark marks stay, so they may think the treatment's not working, when in fact this is just a footprint of what was, so that additional counseling can help them adhere to treatment.

But then after four weeks I see them back three months later, I get them to that point where things are in good shape, and then we spread out the visit, so again that hand holding, I think, helps the process, but I also tell them, you know what, if we're not where we need to be, I have a lot of other targeted treatments that I can give you. We'll just take it step by step, and just know this is not your only option, but it is a lot of counseling, hand-holding, and remembering at the end of the day this is hard on them. They're living with their AD every single day, so all we can do is just help them and guide them through the process.

HCPLive: How do you address concerns over adherence in atopic dermatitis management?

Shahriari: I don't always ask them about how often they are taking this medicine, or how often they are injecting it. I ask them, ‘How many injections did you forget, how many pills did you forget?’ I think that kind of opens the door to a more truthful answer. You may not necessarily get the right answer that you're looking for, but part of it is that part of it is just looking at their skin. If there is a drug that should be working and an individual's not getting better. I start to wonder, ‘What is going on here?’

I remember actually one of my patients back in the day, and this was for psoriasis, not for eczema. It was a child who was on one of the blockbuster medicines that worked so fast. Every visit he would see me, nothing had changed, and I was like, this is very odd. So I asked the mom, are you sure he's taking it? And she was like, oh yeah, he's doing his own injections. I'm like, can you just go and check?

They went to the basement; there was a fridge full of injectable medicine. Then we realized, okay, someone needs to be monitoring it. But you have that gut instinct. I think we're kind of like detectives in dermatology, where you get that spidey sense that tells you something is off. Then I start to look for other reasons why their skin is not responding, and sometimes adherence becomes the main reason.

HCPLive: You presented during a session titled ‘Medical Crossfire.’ What atopic dermatitis treatments were highlighted during this panel discussion?

Shahriari: We did something fun this year where each of us decided to take a drug class and really advocate for that specific drug class, whether or not we feel that way, but we were going to go to town. This is our drug; everything about it is number one, everybody else is number two. We're really going to help the audience see in that art of therapy selection why you would pick one drug class versus another, and how you can best match the treatment to the person in front of you.

We're using an ‘Avengers’ theme, so each of the drugs is going to be represented by an Avenger. Hopefully, there are some Marvel universe people who are watching this who are interested. I think it's a very unique approach, and hopefully it'll be memorable for the audience. They can take some key pearls back to clinical practice.

HCPLive: What developments are you most excited about right now outside of this conference?

Shahriari: I'm the host of the Medical Sisterhood, which is a podcast that I developed a little over a year ago with the help of HCPLive. It is dedicated to women's empowerment in dermatology, and I love that it's really kind of taken a life of its own at this point, where we're really helping not only women in dermatology, but also across the landscape. Women who are professionals, working moms, really. Helping them to better understand how they can reach work-life balance, and better understand the challenges that everybody goes through.

It’s to help people kind of see that what you see on the outside is oftentimes people's highlight reel, but there's a lot of behind the scenes that everyone goes through. That can hopefully help ground them. Thus far, we've been focusing on work-life balance and establishing that sisterhood. Moving forward, we're going to give it more of a medical twist and see how we can better apply this sisterhood to having more connections in the field of dermatology.

Disclosures: AbbVie, Apogee, Arcutis, Bristol Myers Squibb, Dermavant, Galderma, Incyte, Johnson & Johnson, LEO, Lilly USA, Novartis, Regeneron, Sanofi-Genzyme, Takeda, UCB, Pfizer, and others.

References

1. Nguyen H, Bunick C, Cotter D, Shahriari M. Medical Crossfire and Clinical Case Challenge. Session presented at: 2026 Revolutionizing Atopic Dermatitis Conference; June 17-19, 2026; Nashville, TN.