Emma Guttman-Yassky, MD, PhD, Highlights the Potential for Disease Modification in Atopic Dermatitis

Emma Guttman-Yassky, MD, PhD, professor of dermatology and immunology and the health system chair of the department of dermatology at the Icahn School of Medicine at Mount Sinai, is widely recognized for her pioneering work on the role of the OX40 and OX40L pathways in the pathophysiology of atopic dermatitis and on pharmacotherapies that target the costimulatory pathway.

Along with several of her colleagues, Guttman-Yassky presented recent data on the OX40 inhibitor rocatinlimab for the treatment of atopic dermatitis at the 2025 European Academy of Dermatology and Venerology Annual Meeting. Results were shared from the phase 3 ROCKET clinical trial program, conducted under the auspices of rocatinlimab codevelopers, Amgen and Kyowa Kirin.

Guttman-Yassky spoke recently with Patient Care^© about the potential of the novel class of drugs. She explained that unlike currently available biologic medications that primarily target type 2 cytokines such as IL-4, IL-13, or IL-31 to suppress inflammation and control symptoms, OX40 inhibitors may offer the possibility of altering the underlying immune dysregulation that drives chronic AD rather than simply managing flares.¹

By blocking OX40 signaling, rocatinlimab and similar drugs under investigation, may attenuate both type 2 and non-type 2 immune responses, a mechanism that would broaden class efficacy across AD disease phenotypes. Researchers posit the mechanism has the capacity to reset immune pathways and extend disease control beyond active treatment, an effect not typically seen with current type 2-targeted therapies.¹

In the video segment above, Guttman-Yassky noted that OX40 inhibitors may take longer to achieve visible clinical efficacy compared with IL-4/IL-13 or JAK-targeting agents. She underscored, however, that people who have had AD most of their lives may be willing to wait for improvement if that translates more durable disease remission. In phase 3 studies within the ROCKET clinical trial program, rocatinlimab has demonstrated encouraging results, with patients showing continued improvement over extended follow-up.²

The following transcript has been lightly edited for style and flow.

Emma Guttman-Yassky, MD, PhD. So this class of drugs is exciting to me because it brings the idea of disease modification. We need to remember that patients with atopic dermatitis have lived with the disease their whole life, so they can wait a little longer for improvement—especially when there is the potential for true disease modification. From the data, when you add topical steroids, of course you see better improvement. And in real life, everybody uses topicals, so patients will have a way to control the disease during the period when the drug needs time to kick in. It takes a little longer to see results, but once it starts working, I believe it may give patients clearance for longer periods. That, of course, will depend on what we see in the continuation of these phase 3 studies. So I do think this is a very exciting new avenue for thinking about the disease.

The other thing that excites me is that, unlike targeting only the type 2 pathway—which helps only patients driven by that pathway—eczema is not one size fits all. We have different patients with different phenotypes, and to increase responses across more patients, I think this class of drugs may be able to do that. I expect we’ll see that more clearly at week 48, when more patients show responses. Because while type 2 targeting drugs act only on type 2 cells, these drugs affect memory cells and other activated cells as well. So they may be able to reach a broader range of patients.

References

1. Lee MS, Onwuzurike J, Wu Y-L, et al. Efficacy and safety of OX40-receptor targeting with rocatinlimab in moderate-to-severe atopic dermatitis. JAMA Netw Open. 2025;8(9):e2532164. doi:10.1001/jamanetworkopen.2025.32164.
2. Amgen and Kyowa Kirin announce top-line results from rocatinlimab ohase 3 ASCEND long-term extension study in adults with moderate to severe atopic dermatitis. News release. Amgen. Published September 8, 2025. Accessed September 9, 2025. https://investors.amgen.com/news-releases/news-release-details/amgen-and-kyowa-kirin-announce-top-line-results-rocatinlimab
3. Guttman-Yassky E, et al. Long-term results from the ROCKET-ASCEND study of rocatinlimab in atopic dermatitis. Abstract presented at: 2025 European Academy of Dermatology and Venerology Annual Meeting; September 17-20, 2025; Paris, France.