In this final episode of our AAD 2026 atopic dermatitis post-game poster series, we’re joined by dermatologist Dr. Julien Ringuet from Quebec City for a practical, no-fluff breakdown of the JADE REAL analysis — and what flexible abrocitinib dosing may actually mean when Monday morning clinic rolls around.

Because in real life, patients do not always follow a tidy trial algorithm. Symptoms flare, itch keeps people up, adherence shifts, priorities change, and sometimes the “right” dose is less of a fixed destination and more of a GPS recalculating in real time. 🧭

Dr. Ringuet walks us through the clinical “so what” behind dose escalation and de-escalation, explaining why moving from 100 mg to 200 mg — or stepping down from 200 mg to 100 mg — should not automatically be seen as failure, overtreatment, or backpedalling.

Instead, flexible dosing may be part of a thoughtful, shared decision-making strategy that better reflects the messy, dynamic reality of moderate-to-severe atopic dermatitis care.

We cover how early reassessment, patient-reported outcomes, itch, sleep, EASI trends, payer flexibility, and treat-to-target thinking all fit into the bigger picture. And yes, we also discuss the real-world art of knowing when to push, when to pause, and when to test the waters with a lower dose. 🌊

✨ Learning Objectives

By the end of this episode, listeners should be able to:

1. Describe how the JADE REAL study design reflects real-world clinical decision-making in moderate-to-severe atopic dermatitis.
2. Explain why dose escalation and de-escalation with abrocitinib may represent intentional treatment optimization rather than treatment failure.
3. Identify practical clinical scenarios where starting at 100 mg versus 200 mg may be appropriate.
4. Discuss how early follow-up, patient-reported outcomes, itch, sleep, and quality-of-life measures can help guide dose adjustment decisions.
5. Recognize key limitations of open-label, real-world evidence when translating study findings into clinical practice.
6. Apply a treat-and-adjust approach to atopic dermatitis management using shared decision-making and individualized treatment goals.

💡 Key Takeaway

Flexible dosing is not a loophole — it is real-world dermatology. The win is not finding one perfect pathway for every patient; it is learning how to reassess early, individualize thoughtfully, and adjust with purpose. 🩺

🎧 Tune in for practical pearls, real-world nuance, and Dr. Ringuet’s post-game analysis on what these data may mean for dermatologists managing AD in everyday practice.

#SkinAndJointsPodcast #AAD2026 #AtopicDermatitis #EczemaCare #Dermatology #PatientReportedOutcomes #JAKInhibitors #abrocitinib #DermatologyEducation #MedicalEducation #HCPeducation #TreatToTarget #InflammatorySkinDisease #ClinicalData #DermTwitter #MedEd #Vodcast #PodcastEpisode #AADDenver #JAK #JAKinhibitor

ABOUT Dr. Julien Ringuet

Dermatologist, Quebec City, QC

Dr Ringuet is a board certified dermatologist who practices in Quebec City as the principal investigator at the Centre de Recherche Dermatologique de Québec (CRDQ).

He completed his medical training (MD) and his post graduate studies in dermatology form Laval University as well as a master in experimental medicine (MSc.) in the field of skin bioengineering at the Laboratoire d’Organogénèse Expérimentale de l’Université Laval (LOEX/CMDGT).

Dr Ringuet and his team of the CRDQ are allowing patient access to quality and innovative clinical research focused on alopecia areata, atopic dermatitis, psoriasis and its variants and vitiligo.

Supported by an IME Grant from PFIZER.

📻www.skinandjoints.ca

✉️info@skinandjoints.ca

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Are We Treating Eczema… or Just Admiring Better Scores? Minimal Disease Activity in Atopic Dermatitis

In this rapid-fire AAD poster recap, dermatologist Dr. Julien Ringuet joins the Skin and Joints podcast to unpack a big idea with a small acronym: MDA — Minimal Disease Activity.

Borrowed from the rheumatology playbook and now making its way into dermatology, MDA asks a deceptively simple question in atopic dermatitis care: Is the patient actually doing well, or do they just look better on paper?

Together, we dive into new treat-to-target data from the AHEAD analysis, comparing abrocitinib and dupilumab through a more holistic lens — one that includes not only skin clearance, but also itch, sleep, quality of life, and the patient’s lived experience. Spoiler: an EASI score may be impressive, but it does not tuck your patient into bed at night.

Dr. Ringuet breaks down how MDA could help clinicians raise the bar in atopic dermatitis management, why early symptom relief matters, where oral JAK inhibitors may fit for selected patients, and why safety, comorbidities, route of administration, patient preference, and long-term strategy still deserve front-row seats in every treatment decision.

This episode is not just about picking a winner between therapies. It is about redefining what “success” should mean in chronic inflammatory skin disease — and avoiding the trap of accepting “better” when patients are still itchy, sleepless, and sidelined from daily life.

By the end of this episode, listeners will be able to:

1. Define Minimal Disease Activity in atopic dermatitis using the AHEAD treat-to-target framework, including both clinician-reported and patient-reported outcomes.
2. Explain why MDA may offer a more patient-centred endpoint than traditional skin-only measures such as EASI 75 or EASI 90.
3. Interpret key findings from the abrocitinib versus dupilumab analysis, including the relevance of early response, week-two separation, and multidimensional disease control.
4. Identify patient profiles where rapid and comprehensive symptom control may influence treatment selection, while balancing safety, comorbidities, monitoring needs, access, and patient preferences.
5. Describe practical ways to integrate a treat-to-target MDA approach into dermatology clinics, using manageable tools such as IGA/BSA or EASI, itch NRS, sleep NRS, and DLQI.
6. Recognize the importance of avoiding therapeutic inertia when patients remain itchy, sleep-deprived, or functionally impaired despite partial improvement.

Minimal Disease Activity may be the dermatology upgrade we did not know we needed: less “your skin looks better” and more “are you sleeping, functioning, and living better?”

#SkinAndJointsPodcast #AAD2026 #AtopicDermatitis #EczemaCare #Dermatology #PatientReportedOutcomes #JAKInhibitors #abrocitinib #DermatologyEducation #MedicalEducation #HCPeducation #TreatToTarget #InflammatorySkinDisease #ClinicalData #DermTwitter #MedEd #Vodcast #PodcastEpisode #AADDenver #JAK #JAKinhibitor

ABOUT Dr. Julien Ringuet

Dermatologist, Quebec City, QC

Dr Ringuet is a board certified dermatologist who practices in Quebec City as the principal investigator at the Centre de Recherche Dermatologique de Québec (CRDQ).
He completed his medical training (MD) and his post graduate studies in dermatology form Laval University as well as a master in experimental medicine (MSc.) in the field of skin bioengineering at the Laboratoire d’Organogénèse Expérimentale de l’Université Laval (LOEX/CMDGT).
Dr Ringuet and his team of the CRDQ are allowing patient access to quality and innovative clinical research focused on alopecia areata, atopic dermatitis, psoriasis and its variants and vitiligo.

Supported by an IME Grant from PFIZER.

📻www.skinandjoints.ca

✉️info@skinandjoints.ca

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

JAKs, Flares & Rescue Plans: The Art of the Atopic Dermatitis Dose-Down 🎙️

In this rapid-fire post-AAD recap, dermatologist Faculty Dr. Julien Ringuet joins the Skin and Joints Podcast to tackle a question that comes up all the time in real-world atopic dermatitis care: once a patient is doing well, can we safely step down therapy without sending their skin into rebellion?

Using newly presented data on abrocitinib dose down-titration from the JADE program, Dr. Ringuet walks through what happens when patients who respond to 200 mg transition to 100 mg for long-term maintenance—and what clinicians should do if disease control starts to slip. Spoiler: stepping down is not a cliff dive.

Along the way, we cover the “so what?” behind the numbers: who may be a good candidate for dose reduction, how to define loss of control beyond just visible skin lesions, why itch and sleep still deserve centre stage, and how shared decision-making can turn a dosing conversation into a true treatment partnership.

This episode is for clinicians who want to move beyond poster reading and into practical, exam-room-ready conversations about JAK inhibitors, maintenance dosing, treat-to-target thinking, flare management, and individualized care in atopic dermatitis.

Learning Objectives 📚

After listening to this episode, listeners should be able to:

1. Describe the clinical rationale for considering abrocitinib dose down-titration in selected patients with atopic dermatitis.
2. Interpret key long-term efficacy and flare data from the JADE Regimen/JADE Extend analyses in the context of real-world maintenance therapy.
3. Identify patient factors that may support or discourage dose reduction, including depth of response, flare history, adherence, follow-up reliability, quality-of-life burden, and patient preferences.
4. Explain how to counsel patients that step-down therapy is an option—not a guarantee—and that itch, sleep disruption, visible flare, and increased topical use can all signal loss of control.
5. Apply a treat-to-target mindset using both clinician-reported outcomes, such as EASI, IGA, and BSA, and patient-reported outcomes, including itch, sleep, satisfaction, and quality of life.
6. Recognize key caveats when applying clinical trial data to real-world practice, including responder-enriched populations, rescue therapy design, and as-observed analyses.

#SkinAndJointsPodcast #AAD2026 #AtopicDermatitis #EczemaCare #Dermatology #PatientReportedOutcomes #JAKInhibitors #abrocitinib #DermatologyEducation #MedicalEducation #HCPeducation #TreatToTarget #InflammatorySkinDisease #ClinicalData #DermTwitter #MedEd #Vodcast #PodcastEpisode #AADDenver #JAK #JAKinhibitor

ABOUT Dr. Julien Ringuet

Dermatologist, Quebec City, QC

Dr Ringuet is a board certified dermatologist who practices in Quebec City as the principal investigator at the Centre de Recherche Dermatologique de Québec (CRDQ).
He completed his medical training (MD) and his post graduate studies in dermatology form Laval University as well as a master in experimental medicine (MSc.) in the field of skin bioengineering at the Laboratoire d’Organogénèse Expérimentale de l’Université Laval (LOEX/CMDGT).
Dr Ringuet and his team of the CRDQ are allowing patient access to quality and innovative clinical research focused on alopecia areata, atopic dermatitis, psoriasis and its variants and vitiligo.

Supported by an IME Grant from PFIZER.

📻www.skinandjoints.ca

✉️info@skinandjoints.ca

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.