Evaluating crisaborole as a treatment option for atopic dermatitis

ABSTRACT

Introduction: Atopic dermatitis (AD) is a chronic and recurrent disease presenting with eczematous lesions and pruritus. It impacts patient and family quality of life, increases morbidity, and accounts for large health-care expenditures. Although nonpharmacologic, topical, and systemic treatments exist, management of AD remains challenging due to limited treatment options. Crisaborole is a topical small molecule inhibitor of phosphodiesterase 4 (PDE4), recently approved for the treatment of AD in the United States.

Areas covered: The authors review crisaborole in the management of AD based on Phase II, Phase III, and post-marketing studies. Pharmacologic properties such as chemistry, pharmacokinetics, pharmacodynamics and metabolism are discussed. A PubMed systematic review was augmented with Google Scholar searches via keyword, Medical Subject Headings (MeSH), and Boolean operation searches.

Expert opinion: Crisaborole showed modest efficacy in short-term trials, but head-to-head trials with topical corticosteroids and tacrolimus are needed to assess its clinical utility. Since crisaborole is non-steroidal, it may reduce the need for topical corticosteroids and address steroid phobia. However, it is likely to suffer from the same factors contributing to intentional non-adherence in topicals: dissatisfaction with efficacy and inconvenience.

KEYWORDS:

• Adult
• AN2728
• atopic dermatitis
• atopic eczema
• children
• crisaborole
• efficacy
• pharmacology
• phosphodiesterase
• topical

Box 1. Drug summary box

Box 1. Drug summary.

Declaration of interest

R Feldman has received research, speaking and/or consulting support from a variety of companies including Galderma, GlaxoSmithKline/Stiefel, Almirall, Leo Pharma, Boehringer Ingelheim, Mylan, Celgene, Pfizer, Valeant, Abbvie, Samsung, Janssen, Eli Lilly and Company, Menlo, Merck and Co, Novartis, Regeneron, Sanofi, Novan, Qurient, National Biological Corporation, Caremark, Advance Medical, Sun Pharma, Suncare Research, Informa, UpToDate and the National Psoriasis Foundation. They are the founder and majority shareholder of www.DrScore.com and part owner of Causa Research, a company dedicated to enhancing patients’ adherence to treatment. Furthermore, LC Strowd has received research, speaking and/or consulting support from Pfizer Inc, Sanofi Regeneron, Galderma, and Actelion. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

One referee declares that they’ve been a site investigator for dupilumab in an adolescent trial and has served on an advisory board of Pfizer Inc back in 2016. Another referee declares to having served as an investigator for Pfizer and has also attended advisory board meetings for Pfizer, who are the vendors of crisaborole ointment. Further to this, the same referee declares that they have also been an investigator and advisor for both Astellas and Novartis, the manufacturing companies of topical tacrolimus and topical pimcrolimus. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This manuscript was not funded.