Crisaborole: Application Pain and Prevention

Madison Anzelc,Craig G Burkhart

doi:10.2174/1874372201913010055

Abstract

In 2016, a new drug, crisaborole, was developed and approved, for the first time in 15 years, as an effective treatment for Atopic Dermatitis (AD). Crisaborole is a topical phosphodiesterase 4 (PDE4) inhibitor, which alleviates AD symptoms, such as pruritis, inflammation, and flares. Similar to other topical treatments like corticosteroids and calcineurin inhibitors, crisaborole has been found to cause pain during application. The pain felt during a topical application can be attributed to many possible causes, such as increased sensitivity to pain-provoking and itch-provoking stimuli, prior inflammation, prior damage, and hypersensitized skin of the patient to which the topical cream is applied. Crisaborole has been reported to be effective, yet the application site pain is a major road bump in the effective treatment of some patients. Some possible ways to circumvent this pain are letting the epidermis soothe and heal before starting crisaborole, starting this treatment modality before the skin has a chance to become irritated and inflamed, and numbing the area with an ice pack prior to topical crisaborole application. Overall, crisaborole has been an effective treatment modality, but further research is necessary to allow for safe use of this life-changing AD topical medication.

Highlights

In 2016, a new drug, crisaborole, was developed and approved, for the first time in 15 years, as an effective treatment for Atopic Dermatitis (AD) [1]
Crisaborole competitively and reversibly inhibits the active binding site of the phosphodiesterase 4 (PDE4) enzyme [2]. This mechanism is effective because, in AD individuals, the PDE4 enzyme is overactive in inflammatory cells, causing a release of cytokines due to increased intracellular cyclic adenosine monophosphate degradation [4 - 10]
Molecular formulas similar to crisaborole have been used in pill forms, but this is the first scientifically supported topical treatment for inhibiting the PDE4 enzyme

Summary

Introduction

In 2016, a new drug, crisaborole, was developed and approved, for the first time in 15 years, as an effective treatment for Atopic Dermatitis (AD) [1]. A study performed by Paller et al [1] found that crisaborole is an effective treatment by showing more patients achieving success on the Static Global Assessment (ISGA) scores when compared to the vehicle, as well as achieving this ISGA score earlier than the vehicle, and even having better outcomes about the clarity of the skin than the All three of these valid treatment modalities have been found to cause pain at the application site [12].

Results

Conclusion