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?”

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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.

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