From the Guidelines
No, Eucrisa (crisaborole) is not a topical calcineurin inhibitor. Eucrisa is a phosphodiesterase-4 (PDE-4) inhibitor that works by blocking the PDE-4 enzyme, which helps reduce inflammation in the skin, as stated in the 2023 guidelines of care for the management of atopic dermatitis in adults with topical therapies 1. This mechanism of action differs from topical calcineurin inhibitors like tacrolimus (Protopic) and pimecrolimus (Elidel), which work by inhibiting the calcineurin enzyme and suppressing T-cell activation in the immune response. Some key points about Eucrisa (crisaborole) include:
- It was approved by the FDA in 2016 for the treatment of mild to moderate atopic dermatitis (eczema) in patients 3 months of age and older, as mentioned in the 2023 guidelines 1.
- It comes as a 2% ointment and is typically applied twice daily to affected areas.
- The different mechanism of action means Eucrisa may be an alternative for patients who cannot tolerate or have not responded well to topical calcineurin inhibitors or corticosteroids, as supported by the Taiwan guidelines for the diagnosis and management of pediatric atopic dermatitis 1. The most recent and highest quality study, published in 2023, found that crisaborole ointment led to a small but significant improvement in dermatitis in adult AD patients, and also found benefit in itch reduction in adult AD 1. Overall, Eucrisa (crisaborole) is a viable treatment option for patients with mild to moderate atopic dermatitis, particularly those who may not respond well to or cannot tolerate topical calcineurin inhibitors or corticosteroids, as indicated by the evidence from the 2023 study 1.
From the Research
Eucrisa (Crisaborole) Mechanism of Action
- Eucrisa (crisaborole) is a novel, anti-inflammatory inhibitor of phosphodiesterase 4 (PDE4) 2, 3, 4, 5
- It is not a topical calcineurin inhibitor, but rather a phosphodiesterase 4 inhibitor 2, 3, 4, 5
Comparison with Topical Calcineurin Inhibitors
- Crisaborole is mentioned to be used alongside topical calcineurin inhibitors as a second-line option for patients who are recalcitrant to or unable to use topical corticosteroids 3
- Topical calcineurin inhibitors have limitations, such as causing burning and stinging, and carrying a theoretical risk of malignancy 4
Efficacy and Safety of Eucrisa
- Eucrisa has been shown to be effective in reducing disease severity and pruritus severity in patients with mild to moderate atopic dermatitis 2, 3, 6
- It has a favorable safety profile, with most treatment-emergent adverse events being of mild to moderate severity and considered unrelated to the study medication 2, 3, 6