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.

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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.

📻www.skinandjoints.ca

✉️info@skinandjoints.ca