Eucrisa: Successful treatment of eczema without steroids?
The FDA approved topical crisaborole ointment ( Eucrisa) for mild to moderate atopic dermatitis in December 2016. This drug hit the shelves this February 6th! This is an exciting event since Eucrisa has the potential to revolutionize the way we treat some cases of atopic dermatitis and chronic eczema. Topical steroids are fast-acting medications that for decades have been the mainstay therapy for eczema and other inflammatory skin rashes. The problem has been that chronic steroid use could lead to stretch marks or thinning of the skin that irreversibly affects skin health. There has also been concerns of steroid absorption in children and whether this has long-term consequences as they grow. While topical steroids are effective, they require ongoing use and the skin may become unresponsive to the medication over time, requiring higher potency steroids for efficacy.
Who can use Eucrisa?
Eucrisa is FDA-approved for ages two through 79 for mild to moderate atopic dermatitis.
How does it work?
Eucrisa is an phosphodiesterase 4 (PD4) inhibitor. The mechanism of action is unknown. It targets this immune molecule and is able to reduce inflammation in the skin.
Side effects to know?
The most common side effect seen during clinical trials was site pain in 4% of those receiving the drug. There is always the potential for allergic reactions to drugs but none were seen during the studies.
Is it worth it?
As a SkinVestment, Eucrisa holds the promise of effective therapy while eliminating steroid-related side effects in patients using this medication to treat mild to moderate eczema. It will not be appropriate for every case of atopic dermatitis and may not fully replace the need for topical steroids in treatment regimens, especially for severe flares. With all new drugs to market, there are many uncertainties regarding access, affordability, and adoption of this drug for every day use.
With retail price around $580 for a 60 gram tube, it will be interesting to see how accessible the manufacturer will make this medication to patients through insurance. Insurance plans may take months to years before adopting Eucrisa to drug formularies, citing that topical steroids are more affordable and equally effective alternatives. As we have seen with non-steroid Protopic and Elidel, just because a non-steroid drug for eczema is FDA-approved and available, insurers may still choose to not make it available to their patients due to costs. As a SkinVestment, this is a great way to treat atopic dermatitis and I hope that Pfizer will make it affordable through partnerships with insurers and cost-cutting rebate cards.
Contact your dermatologist or skin provider about Eucrisa if you suffer with steroid-requiring chronic eczema to see if this would be a worthwhile therapy.