Banner - NPPA Connect
Commentary|Articles|May 14, 2026

Dermatology Times

  • Dermatology Times, May 2026 (Vol. 47. No. 05)
  • Volume 47
  • Issue 05

Recapping the “Must-Know” Information From the 2026 AAD Late-Breaker Sessions—Part 2

Fact checked by: Yasmeen Qahwash
Listen
0:00 / 0:00

Dermatology Times' editor in chief highlights essential late-breaker data from AAD 2026, including upadacitinib, rezpegaldesleukin, icotrokinra, zasocitinib, envudeucitinib, sonelokimab, and more.

The hustle and bustle of the 2026 American Academy of Dermatology (AAD) Annual Meeting in Denver, Colorado, may be over, but the rapid pace of therapeutic innovation in dermatology is not slowing down. Two late-breaker sessions at the AAD meeting covered more than 20 unique therapies across at least 13 different diseases. Here, I will recap some key information that dermatology providers should be aware of, along with how the new data are impacting the field.

Catch up on part 1 here.

Alopecia Areata

The current FDA-approved treatments for alopecia areata (AA) are Janus kinase (JAK) inhibitors baricitinib, ritlecitinib, and deuruxolitinib. Upadacitinib was released in 2025, with impressive phase 3 results at 24 weeks showing that 45% to 55% of patients achieved 80% or more hair regrowth (Severity of Alopecia Tool [SALT] score ≤ 20) and 35% to 47% of patients achieved 90% or more hair regrowth (SALT ≤ 10), positioning it as a potentially best-in-class therapy.1 Rezpegaldesleukin represents a new, differentiated mechanism for treating AA that targets the IL-2 receptor complex to stimulate T regulatory cells that ultimately restore immune homeostasis. In a phase 2b study in AA (REZOLVE-AD; NCT06136741), patients naive to JAK inhibitors or biologics who received rezpegaldesleukin (18 or 24 mg/kg) at week 36 achieved approximately 16% SALT 20 response (vs 6.7% placebo; 9.3% change from baseline), and approximately 11.5% SALT 10 response (vs 0.7% placebo; 10.8% change from baseline).2

Psoriasis and Psoriatic Arthritis

There is much excitement centered around the oral treatment of plaque psoriasis. Already, icotrokinra, a cyclic peptide that binds the IL-23 receptor with picomolar affinity, is FDA approved for the treatment of plaque psoriasis.3 In its phase 3 ICONIC program (NCT06143878), patients with plaque psoriasis treated with icotrokinra achieved Investigator Global Assessment (IGA) 0/1 response rates of 63% to 65% at week 16 (vs 8% placebo; 55%-57% change from baseline). At week 16, rates of 90% or greater reduction in Psoriasis Area and Severity Index (PASI 90) response ranged from 50% to 63% (vs 4% placebo), and PASI 100 response rates ranged from 27% to 33% (vs 1% placebo). Importantly, icotrokinra was superior to deucravacitinib head-to-head by approximately 20 percentage points at week 16 for IGA 0/1 and PASI 90 responses. A recent network meta-analysis suggests icotrokinra has efficacy similar to many of the psoriasis biologics4; however, a matching-adjusted indirect comparison study indicates its efficacy is approximately 10% to 20% below risankizumab, depending on the time point.5

In the late-breaker sessions, the 2 next-generation allosteric tyrosine kinase 2 (TYK2) inhibitors, zasocitinib and envudeucitinib, reported pivotal phase 3 data.6,7 These next-generation TYK2 inhibitors are not deucravacitinib; they are much more, having more than 1,000,000-fold selectivity for TYK2 vs JAK1/2/3, and the phase 3 data confirm this differentiation. In its phase 3 LATITUDE program (NCT06671483) involving more than 1800 patients, zasocitinib met its primary and all 44 ranked secondary end points, including superiority over the PDE4 inhibitor apremilast in a head-to-head comparison. Of patients treated with oral 30 mg once-daily zasocitinib at week 16, more than 50% achieved PASI 90, approximately 30% achieved PASI 100, and response rates increased through week 24. Zasocitinib proved very safe with no new safety signals, and the most common adverse effects were upper respiratory tract infection, nasopharyngitis, and acne. A head-to-head trial with deucravacitinib in plaque psoriasis and a phase 3 trial in psoriatic arthritis are ongoing.6

In its phase 3 ONWARD program (NCT06588738) involving more than 1700 patients, envudeucitinib, like zasocitinib, met its primary end points of PASI 75 and a static Physician Global Assessment score of 0/1. Moreover, approximately 65% of patients receiving envudeucitinib 40 mg twice daily achieved PASI 90 at week 24, and approximately 40% achieved PASI 100. This high efficacy was coupled with dramatic improvements in patient quality of life (QOL), with approximately 50% of patients achieving a Dermatology Life Quality Index score of 0/1 (meaning minimal to no impact on QOL) within 12 weeks of envudeucitinib therapy. A once-daily, extended-release oral pill is under development. Investigation of envudeucitinib in systemic lupus erythematosus (phase 2b LUMUS trial; NCT05966480) is ongoing.7 Together, envudeucitinib, zasocitinib, and icotrokinra are transformational additions to the oral plaque psoriasis treatment landscape, immediately elevating the standard of care substantially beyond apremilast and deucravacitinib.4,6,7

It is no secret that glucagon-like peptide-1 (GLP-1) agonists have stormed the world with their weight loss capabilities. GLP-1 agonists can also improve cardiometabolic function, as demonstrated by the phase 3b TOGETHER-PsA trial (NCT06588296), which evaluated the IL-17A inhibitor ixekizumab plus tirzepatide in adults who are overweight or obese and have psoriatic arthritis, as well as the TOGETHER-PsO trial (NCT06588283), which evaluated the 2 drugs in overweight or obese adults with plaque psoriasis.8 The primary end point in TOGETHER-PsO was the proportion of patients achieving PASI 100 and more than 10% weight loss at week 36. Overall, 27.1% on tirzepatide and ixekizumab met this end point vs 5.8% on ixekizumab alone (P < .001). PASI 100, a key secondary end point, at week 36 was achieved by 40.6% on the combination vs 29.0% on ixekizumab alone (P < .05); this is a 40% relative increase in PASI 100 achievement. The primary end point in TOGETHER-PsA was the proportion of patients achieving a 50% or greater improvement in the American College of Rheumatology criteria and more than 10% weight loss at week 36. Overall, 31.7% of patients on tirzepatide and ixekizumab met this end point vs 0.8% on ixekizumab alone.8

Similarly, 26.3% of patients achieved minimal disease activity on the combination vs 15.3% for those on ixekizumab alone.8 Additionally, high-sensitivity C-reactive protein (hsCRP) was lowered to a greater degree with tirzepatide and ixekizumab (–.79 mg/L from baseline) vs ixekizumab alone (–0.44 mg/L), which is significant because recent research published in cardiology literature validated hsCRP as a clinically relevant predictor of cardiovascular events, such as major adverse cardiovascular events.9 These results strongly support the integration of GLP-1 agonists into the psoriatic disease treatment algorithm.

Vitiligo

There are currently no FDA-approved systemic therapies for vitiligo, but the oral JAK1-selective small molecule inhibitor upadacitinib aims to change that. In 2 phase 3 studies (Viti-Up 1 and 2; NCT06118411) evaluating the efficacy and safety of upadacitinib in treating adolescents and adults with nonsegmental vitiligo, upadacitinib significantly reduced total body (Total Vitiligo Area Scoring Index) and facial (Facial Vitiligo Area Scoring Index) depigmentation. Across the 2 trials, 19% to 22% of patients receiving upadacitinib 15 mg orally achieved a 50% decrease in total body depigmentation (vs 5.9% placebo; P < .001), and 23% to 25% of patients achieved a 75% decrease in facial depigmentation (vs 5.9%-6.9% placebo; P < .001).10 These results show that upadacitinib monotherapy can deliver clinically meaningful improvements for patients with vitiligo. Synergistic results with phototherapy are reasonable to expect.

Hidradenitis Suppurativa 

Patients with moderate to severe hidradenitis suppurativa (HS) continue to need effective therapies. Currently, there are 3 FDA-approved injectable biologics for HS: the tumor necrosis factor-α inhibitor adalimumab, the IL-17A inhibitor secukinumab, and the IL-17A/F inhibitor bimekizumab. At AAD 2026, 2 innovative molecules for HS were presented in the late-breaker sessions: povorcitinib, a new oral JAK1-selective inhibitor, and sonelokimab, a nanobody targeting IL-17A/F.

Povorcitinib was evaluated in adults 18 years and older with moderate to severe HS over 54 weeks in the STOP-HS1 (NCT05620823) and STOP-HS2 (NCT05620836) phase 3 studies. Povorcitinib, at both 45 mg and 75 mg, demonstrated substantial clinical efficacy through week 54, including high response rates across all HS Clinical Response (HiSCR) thresholds. Up to 71.4% of patients receiving povorcitinib achieved HiSCR 50, 57% achieved HiSCR 75, and 29% achieved HiSCR 100 (as observed). Furthermore, there was consistent resolution of all inflammatory lesion types (abscesses [A], nodules [N], and draining tunnels [dT]), with up to 20% of patients achieving complete resolution (ANdT = 0). Meaningful improvements in skin pain (41%-47%), fatigue (49%-58%), and QOL measures were observed. There were low rates of adverse events of special interest, and no new safety signals were observed over the 54 weeks of treatment.11

Sonelokimab is a unique nanobody that binds IL-17A, IL-17F, and serum albumin. The binding of serum albumin may accomplish several goals: extending the drug’s half-life, enriching the drug at sites of chronic inflammation and edema, and enhancing tissue penetration. At AAD 2026, results from week 40 of treatment in the phase 3 VELA-1 (NCT06411899) and VELA-2 (NCT07007637) trials were presented. For patients with moderate to severe HS who received sonelokimab, 62% achieved HiSCR 75 response in both trial arms, and 32% achieved HiSCR 100 (as observed). The significant clinical responses were accompanied by marked improvements in patient-reported outcomes; for example, skin pain reduced by 41%. Through 40 weeks, there were no new safety signals. Sonelokimab is also undergoing phase 3 evaluation in an adolescent-only trial for moderate to severe HS, called VELA-TEEN (NCT06768671).12

Dermatomyositis

Last but not least, brepocitinib is an oral JAK1/TYK2 inhibitor that completed a phase 3 clinical trial (VALOR; NCT05437263) in the treatment of patients with dermatomyositis. Unlike the allosteric TYK2 inhibitors in psoriasis, brepocitinib inhibits the kinase domain of TYK2. In VALOR, 241 patients were randomly assigned to brepocitinib 30 mg, 15 mg, or placebo and evaluated over 52 weeks of therapy. Patients were on background corticosteroid therapy, with a protocol mandating tapering to less than 5 mg daily prednisone by week 36. The primary end point, mean Total Improvement Score, was achieved by 46.5% of patients in the 30-mg brepocitinib arm compared with 31.2% in placebo (15.3% change from baseline; P < .001), and reflected significant improvements in skin disease, muscle disease, and physical functioning. The true power and benefit of brepocitinib for dermatomyositis is reflected in the corticosteroid tapering results, where, by weeks 48 through 52, 62% of patients on brepocitinib tapered to less than 2.5 mg prednisone daily compared with only 34.4% on placebo.13,14 Brepocitinib is poised to be a transformational therapy for patients with dermatomyositis and inherently very complicated health comorbidities. To learn more about brepocitinib and its performance in the VALOR trial, please read the recent Dermatology Times article on the topic.

To conclude, I have selected several informative data releases presented at the AAD 2026 late-breaker sessions. Although these therapies represent some of the hottest advances in dermatology, there are many others that space simply does not allow for me to discuss at this time; however, please stay tuned to Dermatology Times as we continue to report on these breakthroughs throughout the year.

References

  1. AbbVie announces positive topline results from phase 3 UP-AA trial evaluating upadacitinib (Rinvoq) for alopecia areata. News release. AbbVie. July 30, 2025. Accessed April 17, 2026. https://news.abbvie.com/2025-07-30-AbbVie-Announces-Positive-Topline-Results-from-Phase-3-UP-AA-Trial-Evaluating-Upadacitinib-RINVOQ-R-for-Alopecia-Areata
  2. Rosmarin D. Novel regulatory T-cell enhancing biologic rezpegaldesleukin: phase 2b efficacy and safety results following 36-weeks of therapy in severe-to-very-severe alopecia areata. Presented at: 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, CO.
  3. FDA approval of Icotyde (icotrokinra) ushers in new era for first-line systemic treatment of plaque psoriasis with a targeted oral peptide. News release. Johnson & Johnson. March 18, 2026. Accessed April 17, 2026. https://www.jnj.com/media-center/press-releases/fda-approval-of-icotyde-icotrokinra-ushers-in-new-era-for-first-line-systemic-treatment-of-plaque-psoriasis-with-a-targeted-oral-peptide
  4. Armstrong A, Hashim M, Feghelm L, et al. Comparative analysis of icotrokinra and approved advanced treatments for achievement of completely clear skin in patients with moderate-to-severe psoriasis: a systematic literature review and network meta-analysis. Presented at: Maui Derm Hawaii 2026; January 25-29, 2026; Maui, HI.
  5. Crowley J, Song E, Strober B, et al. Matching-adjusted indirect comparison of risankizumab versus icotrokinra in adult patients with moderate-to-severe plaque psoriasis. Presented at: Maui Derm Hawaii 2026; January 25-29, 2026; Maui, HI.
  6. Gooderham M. Once-daily oral zasocitinib demonstrates rapid and reproducible skin clearance with a consistent safety profile in moderate-to-severe plaque psoriasis: results from two randomized phase 3 trials (LATITUDE-PsO-3001 and 3002). Presented at: 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, CO.
  7. Blauvelt A. Envudeucitinib (ESK-001) in moderate-to-severe plaque psoriasis: 24-week results from the randomized, double-blind, active comparator- and placebo-controlled, phase 3 ONWARD 1 and 2 studies. Presented at: 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, CO.
  8. Merola J. Concomitant therapy with ixekizumab plus tirzepatide in adults with psoriatic arthritis and overweight or obesity demonstrated superior disease control compared to ixekizumab alone: results from the Ph3b TOGETHER-PsA trial. Presented at: 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, CO.
  9. Kurt B, Reugels M, Schneider KM, et al. C-reactive protein and cardiovascular risk in the general population. Eur Heart J. Published online December 11, 2025. doi:10.1093/eurheartj/ehaf937
  10. Passeron T. Efficacy and safety of upadacitinib in adolescents and adults for treatment of non-segmental vitiligo: results of two phase 3 studies (Viti-Up). Presented at: 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, CO.
  11. Porter M. Povorcitinib in patients with moderate to severe hidradenitis suppurativa: 54-week efficacy and safety results from the STOP-HS1 & STOP-HS2 phase 3 studies. Presented at: 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, CO.
  12. Kimball A. Sonelokimab in moderate-to-severe HS: long-term results through week 40 of two phase 3 trials. Presented at: 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, CO.
  13. Vleugels RA. Brepocitinib achieves rapid and sustained control of cutaneous disease activity, itch, and skin-related quality of life in dermatomyositis: results from the phase 3 VALOR trial. Presented at: 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, CO.
  14. Vleugels RA, Paik JJ, Bauer Ventura I, et al. A phase 3 trial of brepocitinib in dermatomyositis. N Engl J Med. 2026;394(19):1883-1893. doi:10.1056/NEJMoa2503531

Latest CME