OX40‑Targeted Therapy Among Dr. Hensin Tsao’s Highlights at Maui Derm Hawaii 2026
A novel immune pathway that may redefine atopic dermatitis (AD) treatment paradigms was among the highlights presented by Hensin Tsao, MD, in his conference-opening presentation at Maui Derm Hawaii 2026.
Melanoma immunotherapy and various other topics were covered, but perhaps the most potentially impactful development was the OX40‑targeted therapeutic strategy and the latest clinical data supporting its efficacy and safety.
Traditionally, moderate‑to‑severe AD treatments have focused on inhibiting Th2‑mediated inflammation using biologics or JAK inhibitors. However, recent research has highlighted the OX40/OX40 ligand pathway as a central driver of pathogenic T‑cell activity and chronic inflammation in AD. By selectively inhibiting this pathway, new biologics aim to rebalance immune responses at a deeper mechanistic level.1
Rocatinlimab, an anti‑OX40 monoclonal antibody, has emerged as a leading candidate in this therapeutic class, Dr. Tsao noted. Two pivotal global Phase 3 trials, ROCKET-IGNITE and ROCKET-HORIZON, evaluated its efficacy and safety in adults with moderate‑to‑severe AD.
In the ROCKET‑HORIZON trial, rocatinlimab significantly improved skin clearance and disease severity compared with placebo at 24 weeks, as measured by co‑primary endpoints including Eczema Area and Severity Index (EASI) 75 and Validated Investigator Global Assessment (vIGA‑AD) scores of 0 or 1. Secondary endpoints addressing itch, pain, and quality of life also favored rocatinlimab, with a safety profile comparable to placebo.
Dr. Tsao highlighted how the OX40‑targeted approach is mechanistically distinct from existing therapies, focusing on modulating T‑cell memory and effector populations that contribute to chronic disease and flare susceptibility. Research suggests that targeting this co‑stimulatory pathway may deliver incremental and sustained clinical benefit, potentially addressing unmet needs in patients who have inadequate responses to current standards of care.
Dr. Tsao noted that while these results represent a major advance, ongoing research is needed to fully characterize long‑term outcomes, real‑world effectiveness, and optimal positioning of OX40‑targeted therapies within the broader AD treatment armamentarium. Integration with existing treatment strategies, including biologics and JAK inhibitors, will be an important focus of future clinical investigation.
- Guttman-Yassky E, et al. Efficacy and safety of rocatinlimab for the treatment of moderate-to-severe atopic dermatitis in ROCKET-IGNITE and ROCKET-HORIZON: two global, double-blind, placebo-controlled, randomised phase 3 clinical trials. Lancet. 2026 Jan 3;407(10523):53-66. doi: 10.1016/S0140-6736(25)01865-3. Epub 2025 Nov 25. Erratum in: Lancet. 2026 Jan 3;407(10523):30. doi: 10.1016/S0140-6736(25)02603-0.