Rocatinlimab for atopic dermatitis: Rebalancing immunity by targeting pathogenic T cells

This commentary provides a comprehensive mechanistic and clinical overview of rocatinlimab, a first-in-class anti-OX40 monoclonal antibody, as a novel therapeutic strategy for moderate-to-severe atopic dermatitis (AD). Building on the landmark phase 3 trial results from ROCKET-IGNITE and ROCKET-HORIZON (Guttman-Yassky et al., The Lancet, 2025), we contextualize rocatinlimab within the evolving AD therapeutic landscape, emphasizing its unique mechanism of action: selective depletion of pathogenic OX40+ T cells via antibody-dependent cellular cytotoxicity (ADCC), leading to immune rebalancing without broad immunosuppression.