Crisaborole, sold under the brand name Eucrisa among others, is a

nonsteroidal A nonsteroidal compound is a drug that is not a steroid nor a steroid derivative. Nonsteroidal anti-inflammatory drugs (NSAIDs) are distinguished from corticosteroids as a class of anti-inflammatory agents. List of nonsteroidal steroid receptor mo ...

topical medication A topical medication is a medication that is applied to a particular place on or in the body. Most often topical medication means application to body surfaces such as the skin or mucous membranes to treat ailments via a large range of classes ...

used for the treatment of mild-to-moderate atopic dermatitis (eczema) in adults and children. The most common side effects are reactions at the application site (including burning or stinging). Crisaborole is a phosphodiesterase 4 (PDE-4) inhibitor, although its specific mechanism of action in atopic dermatitis is not known.

Side effects

At the site of application, crisaborole may cause burning or stinging. Rarely, there may be an

allergic reaction Allergies, also known as allergic diseases, refer a number of conditions caused by the hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic derma ...

Medical uses

In the US, crisaborole is indicated for topical treatment of mild to moderate atopic dermatitis in people three months of age and older. In the EU, crisaborole was authorized for treatment of mild to moderate atopic dermatitis in people two years of age and older with ≤ 40% body surface area (BSA) affected.

Pharmacology

Pharmacodynamics

Crisaborole is a

phosphodiesterase-4 inhibitor A phosphodiesterase-4 inhibitor, commonly referred to as a PDE4 inhibitor, is a drug used to block the degradative action of phosphodiesterase 4 (PDE4) on cyclic adenosine monophosphate (cAMP). It is a member of the larger family of Phosphodiester ...

, mainly acting on phosphodiesterase 4B (PDE4B), which causes inflammation. Chemically, crisaborole is a phenoxybenzoxaborole. Inhibition of PDE4B appears to suppress the release of

tumor necrosis factor alpha Tumor necrosis factor (TNF, cachexin, or cachectin; formerly known as tumor necrosis factor alpha or TNF-α) is an adipokine and a cytokine. TNF is a member of the TNF superfamily, which consists of various transmembrane proteins with a homolo ...

(TNFα),

interleukin-12 Interleukin 12 (IL-12) is an interleukin that is naturally produced by dendritic cells, macrophages, neutrophils, and human B- lymphoblastoid cells ( NC-37) in response to antigenic stimulation. IL-12 belongs to the family of interleukin-12. ...

(IL-12), IL-23 and other cytokines, proteins believed to be involved in the immune response and inflammation. People with atopic dermatitis produce high levels of proteins called cytokines, which can cause the inflammation of the skin seen in dermatitis. Crisaborole blocks the release of certain cytokines involved in the inflammation process such as tumor necrosis factor alpha, interleukins (IL‑2, IL-4, IL-5), and interferon gamma. By blocking their release, crisaborole is expected to ease the inflammation and therefore relieve symptoms of the disease.

Chemistry

Crisaborole (chemical name: 4- 1-hydroxy-1,3-dihydro-2,1-benzoxaborol-5-yl)oxyenzonitrile) is a member of the class of benzoxaboroles characterized by the presence of a

boronic acid A boronic acid is an organic compound related to boric acid () in which one of the three hydroxyl groups () is replaced by an alkyl or aryl group (represented by R in the general formula ). As a compound containing a carbon–boron bond, membe ...

hemiester with a phenolic ether and a nitrile. Crisaborole crystallizes into two polymorphs that differ in the conformation of the oxaborole ring. A

cocrystal Cocrystals are "solids that are crystalline single phase materials composed of two or more different molecular or ionic compounds generally in a stoichiometric ratio which are neither solvates nor simple salts." A broader definition is that cocryst ...

with 4,4'-bipyridine has been prepared and studied by

X-ray crystallography X-ray crystallography is the experimental science determining the atomic and molecular structure of a crystal, in which the crystalline structure causes a beam of incident X-rays to diffract into many specific directions. By measuring the angles ...

History

Crisaborole was developed by

Anacor Pfizer Inc. ( ) is an American multinational pharmaceutical and biotechnology corporation headquartered on 42nd Street in Manhattan, New York City. The company was established in 1849 in New York by two German entrepreneurs, Charles Pfizer ...

Pharmaceuticals for the topical treatment of

psoriasis Psoriasis is a long-lasting, noncontagious autoimmune disease characterized by raised areas of abnormal skin. These areas are red, pink, or purple, dry, itchy, and scaly. Psoriasis varies in severity from small, localized patches to complete ...

. During preclinical and clinical development, crisaborole was called AN2728 and PF-06930164. The drug was assumed to be potential $2bn-a-year blockbuster, when Pfizer acquired Anacor Pharmaceuticals. However, the drug was commercially not successful, reaching only in sales in 2018, and in sales in 2019. Crisaborole was approved for use in the United States in December 2016 and for use in Canada in June 2018. The safety and efficacy of crisaborole were established in two placebo-controlled trials with a total of 1,522 participants ranging in age from two years of age to 79 years of age, with mild to moderate atopic dermatitis. In both trials participants received treatment with either crisaborole or placebo twice daily for 28 days. Neither the participants nor the health care providers knew which treatment was being given until after the trials were completed. Overall, participants receiving crisaborole achieved greater response with clear or almost clear skin after 28 days of treatment. The trials were conducted in the US. Crisaborole, approved for the treatment of mild to moderate atopic dermatitis in the European Union, has been rapidly withdrawn from the European market (March 2020 - February 2022). Text was copied from this source which is © European Medicines Agency. Reproduction is authorized provided the source is acknowledged.

References

External links

* {{Portal bar , Medicine Ethers Nitriles Organoboron compounds PDE4 inhibitors Phosphodiesterase inhibitors