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Published in: American Journal of Clinical Dermatology 2/2020

Open Access 01-04-2020 | Pharmacokinetics | Original Research Article

Safety, Effectiveness, and Pharmacokinetics of Crisaborole in Infants Aged 3 to < 24 Months with Mild-to-Moderate Atopic Dermatitis: A Phase IV Open-Label Study (CrisADe CARE 1)

Authors: Joel Schlessinger, Julie S. Shepard, Richard Gower, John C. Su, Charles Lynde, Amy Cha, William C. Ports, Vivek Purohit, Liza Takiya, John L. Werth, Chuanbo Zang, Bonnie Vlahos, on behalf of the CARE 1 Investigators

Published in: American Journal of Clinical Dermatology | Issue 2/2020

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Abstract

Background

Crisaborole ointment, 2%, is a nonsteroidal phosphodiesterase 4 inhibitor for the treatment of mild-to-moderate atopic dermatitis (AD).

Objectives

The aim of this study was to evaluate the safety, effectiveness, and pharmacokinetics (PK) of crisaborole in infants aged 3 to < 24 months with mild-to-moderate AD in an open-label study.

Methods

Infants (3 to < 24 months) with Investigator’s Static Global Assessment (ISGA) of mild (2) or moderate (3) and percentage of treatable body surface area (%BSA) ≥ 5 received crisaborole twice daily for 28 days; a cohort with moderate AD per ISGA and %BSA ≥ 35 were included in a PK analysis. Endpoints included safety (primary), efficacy, and PK (exploratory).

Results

Included were 137 infants total (mean age [SD], 13.6 months [6.42]), with 21 in the PK cohort (12.7 months [6.58]). Treatment-emergent adverse events (TEAEs) were reported for 88 (64.2%) patients (98.9% rated as mild/moderate). TEAEs were considered treatment-related for 22 patients (16.1%); most frequently reported were application site pain (3.6%), application site discomfort (2.9%), and erythema (2.9%). ISGA clear/almost clear with ≥ 2-grade improvement at day 29 was achieved by 30.2% of patients. From baseline to day 29, mean percentage change in Eczema Area and Severity Index score was − 57.5%, and mean change in Patient-Oriented Eczema Measure total score was − 8.5. Crisaborole systemic exposures in infants were characterized and, based on nonlinear regression analysis, were comparable with that in patients aged ≥ 2 years.

Conclusions

In this open-label study, crisaborole was well tolerated and effective in infants (3 to < 24 months) with mild-to-moderate AD with systemic exposures similar to patients aged ≥ 2 years.

Clinical Trial Registration

NCT03356977.
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Literature
1.
2.
go back to reference Lewis-Jones S. Quality of life and childhood atopic dermatitis: the misery of living with childhood eczema. Int J Clin Pract. 2006;60(8):984–92.CrossRef Lewis-Jones S. Quality of life and childhood atopic dermatitis: the misery of living with childhood eczema. Int J Clin Pract. 2006;60(8):984–92.CrossRef
3.
go back to reference Eichenfield LF, Ellis CN, Mancini AJ, Paller AS, Simpson EL. Atopic dermatitis: epidemiology and pathogenesis update. Semin Cutan Med Surg. 2012;31(3 Suppl):S3–5.CrossRef Eichenfield LF, Ellis CN, Mancini AJ, Paller AS, Simpson EL. Atopic dermatitis: epidemiology and pathogenesis update. Semin Cutan Med Surg. 2012;31(3 Suppl):S3–5.CrossRef
4.
go back to reference Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL, et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol. 2014;70(2):338–51.CrossRef Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL, et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol. 2014;70(2):338–51.CrossRef
5.
go back to reference Kim SH, Hur J, Jang JY, Park HS, Hong CH, Son SJ, et al. Psychological distress in young adult males with atopic dermatitis: a cross-sectional study. Medicine (Baltimore). 2015;94(23):e949.CrossRef Kim SH, Hur J, Jang JY, Park HS, Hong CH, Son SJ, et al. Psychological distress in young adult males with atopic dermatitis: a cross-sectional study. Medicine (Baltimore). 2015;94(23):e949.CrossRef
6.
go back to reference Paller AS, Tom WL, Lebwohl MG, Blumenthal RL, Boguniewicz M, Call RS, et al. Efficacy and safety of crisaborole ointment, a novel, nonsteroidal phosphodiesterase 4 (PDE4) inhibitor for the topical treatment of atopic dermatitis (AD) in children and adults. J Am Acad Dermatol. 2016;75(3):494–503.e6.CrossRef Paller AS, Tom WL, Lebwohl MG, Blumenthal RL, Boguniewicz M, Call RS, et al. Efficacy and safety of crisaborole ointment, a novel, nonsteroidal phosphodiesterase 4 (PDE4) inhibitor for the topical treatment of atopic dermatitis (AD) in children and adults. J Am Acad Dermatol. 2016;75(3):494–503.e6.CrossRef
7.
go back to reference Eichenfield LF, Call RS, Forsha DW, Fowler J Jr, Hebert AA, Spellman M, et al. Long-term safety of crisaborole ointment 2% in children and adults with mild to moderate atopic dermatitis. J Am Acad Dermatol. 2017;77(4):641–649 e5.CrossRef Eichenfield LF, Call RS, Forsha DW, Fowler J Jr, Hebert AA, Spellman M, et al. Long-term safety of crisaborole ointment 2% in children and adults with mild to moderate atopic dermatitis. J Am Acad Dermatol. 2017;77(4):641–649 e5.CrossRef
9.
10.
go back to reference Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol Suppl (Stockh). 1980;92(suppl):44–7. Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol Suppl (Stockh). 1980;92(suppl):44–7.
11.
go back to reference Bissonnette R, Papp KA, Poulin Y, Gooderham M, Raman M, Mallbris L, et al. Topical tofacitinib for atopic dermatitis: a phase IIa randomized trial. Br J Dermatol. 2016;175(5):902–11.CrossRef Bissonnette R, Papp KA, Poulin Y, Gooderham M, Raman M, Mallbris L, et al. Topical tofacitinib for atopic dermatitis: a phase IIa randomized trial. Br J Dermatol. 2016;175(5):902–11.CrossRef
12.
go back to reference Barbier N, Paul C, Luger T, Allen R, De Prost Y, Papp K, et al. Validation of the Eczema Area and Severity Index for atopic dermatitis in a cohort of 1550 patients from the pimecrolimus cream 1% randomized controlled clinical trials programme. Br J Dermatol. 2004;150(1):96–102.CrossRef Barbier N, Paul C, Luger T, Allen R, De Prost Y, Papp K, et al. Validation of the Eczema Area and Severity Index for atopic dermatitis in a cohort of 1550 patients from the pimecrolimus cream 1% randomized controlled clinical trials programme. Br J Dermatol. 2004;150(1):96–102.CrossRef
13.
go back to reference Charman CR, Venn AJ, Williams HC. The patient-oriented eczema measure: development and initial validation of a new tool for measuring atopic eczema severity from the patients’ perspective. Arch Dermatol. 2004;140(12):1513–9.CrossRef Charman CR, Venn AJ, Williams HC. The patient-oriented eczema measure: development and initial validation of a new tool for measuring atopic eczema severity from the patients’ perspective. Arch Dermatol. 2004;140(12):1513–9.CrossRef
14.
go back to reference Zane LT, Kircik L, Call R, Tschen E, Draelos ZD, Chanda S, et al. Crisaborole topical ointment, 2% in patients 2 to 17 years of age with atopic dermatitis: a phase 1b, open-label, maximal-use systemic exposure (MUSE) study. Pediatr Dermatol. 2016;33(4):380–7.CrossRef Zane LT, Kircik L, Call R, Tschen E, Draelos ZD, Chanda S, et al. Crisaborole topical ointment, 2% in patients 2 to 17 years of age with atopic dermatitis: a phase 1b, open-label, maximal-use systemic exposure (MUSE) study. Pediatr Dermatol. 2016;33(4):380–7.CrossRef
15.
go back to reference Purohit V, Riley S, Tan H, Ports WC. Patient and disease characteristic predictors of systemic exposure to crisaborole. Presented at: 2019 ACCP Annual Meeting (American College of Clinical Pharmacology); September 15–17, 2019; Chicago, Illinois; Poster 080. Purohit V, Riley S, Tan H, Ports WC. Patient and disease characteristic predictors of systemic exposure to crisaborole. Presented at: 2019 ACCP Annual Meeting (American College of Clinical Pharmacology); September 15–17, 2019; Chicago, Illinois; Poster 080.
16.
go back to reference Tom WL, Van Syoc M, Chanda S, Zane LT. Pharmacokinetic profile, safety, and tolerability of crisaborole topical ointment, 2% in adolescents with atopic dermatitis: an open-label phase 2a study. Pediatr Dermatol. 2016;33(2):150–9.CrossRef Tom WL, Van Syoc M, Chanda S, Zane LT. Pharmacokinetic profile, safety, and tolerability of crisaborole topical ointment, 2% in adolescents with atopic dermatitis: an open-label phase 2a study. Pediatr Dermatol. 2016;33(2):150–9.CrossRef
17.
go back to reference Martin PE, Koplin JJ, Eckert JK, Lowe AJ, Ponsonby AL, Osborne NJ, et al. The prevalence and socio-demographic risk factors of clinical eczema in infancy: a population-based observational study. Clin Exp Allergy. 2013;43(6):642–51.PubMed Martin PE, Koplin JJ, Eckert JK, Lowe AJ, Ponsonby AL, Osborne NJ, et al. The prevalence and socio-demographic risk factors of clinical eczema in infancy: a population-based observational study. Clin Exp Allergy. 2013;43(6):642–51.PubMed
18.
go back to reference Hengge UR, Ruzicka T, Schwartz RA, Cork MJ. Adverse effects of topical glucocorticosteroids. J Am Acad Dermatol. 2006;54(1):1–15 (quiz 6–8).CrossRef Hengge UR, Ruzicka T, Schwartz RA, Cork MJ. Adverse effects of topical glucocorticosteroids. J Am Acad Dermatol. 2006;54(1):1–15 (quiz 6–8).CrossRef
19.
go back to reference Luger T, Boguniewicz M, Carr W, Cork M, Deleuran M, Eichenfield L, et al. Pimecrolimus in atopic dermatitis: consensus on safety and the need to allow use in infants. Pediatr Allergy Immunol. 2015;26(4):306–15.CrossRef Luger T, Boguniewicz M, Carr W, Cork M, Deleuran M, Eichenfield L, et al. Pimecrolimus in atopic dermatitis: consensus on safety and the need to allow use in infants. Pediatr Allergy Immunol. 2015;26(4):306–15.CrossRef
20.
go back to reference Bissonnette R, Pavel AB, Diaz A, Werth JL, Zang C, Vranic I, et al. Crisaborole and atopic dermatitis skin biomarkers: an intrapatient randomized trial. J Allergy Clin Immunol. 2019;144(5):1274–89.CrossRef Bissonnette R, Pavel AB, Diaz A, Werth JL, Zang C, Vranic I, et al. Crisaborole and atopic dermatitis skin biomarkers: an intrapatient randomized trial. J Allergy Clin Immunol. 2019;144(5):1274–89.CrossRef
21.
go back to reference Schram ME, Spuls PI, Leeflang MM, Lindeboom R, Bos JD, Schmitt J. EASI, (objective) SCORAD and POEM for atopic eczema: responsiveness and minimal clinically important difference. Allergy. 2012;67(1):99–106.CrossRef Schram ME, Spuls PI, Leeflang MM, Lindeboom R, Bos JD, Schmitt J. EASI, (objective) SCORAD and POEM for atopic eczema: responsiveness and minimal clinically important difference. Allergy. 2012;67(1):99–106.CrossRef
22.
go back to reference Gaunt DM, Metcalfe C, Ridd M. The Patient-Oriented Eczema Measure in young children: responsiveness and minimal clinically important difference. Allergy. 2016;71(11):1620–5.CrossRef Gaunt DM, Metcalfe C, Ridd M. The Patient-Oriented Eczema Measure in young children: responsiveness and minimal clinically important difference. Allergy. 2016;71(11):1620–5.CrossRef
23.
go back to reference Barrett A, Hahn-Pedersen J, Kragh N, Evans E, Gnanasakthy A. Patient-reported outcome measures in atopic dermatitis and chronic hand eczema in adults. Patient. 2019;12(5):445–59.CrossRef Barrett A, Hahn-Pedersen J, Kragh N, Evans E, Gnanasakthy A. Patient-reported outcome measures in atopic dermatitis and chronic hand eczema in adults. Patient. 2019;12(5):445–59.CrossRef
Metadata
Title
Safety, Effectiveness, and Pharmacokinetics of Crisaborole in Infants Aged 3 to < 24 Months with Mild-to-Moderate Atopic Dermatitis: A Phase IV Open-Label Study (CrisADe CARE 1)
Authors
Joel Schlessinger
Julie S. Shepard
Richard Gower
John C. Su
Charles Lynde
Amy Cha
William C. Ports
Vivek Purohit
Liza Takiya
John L. Werth
Chuanbo Zang
Bonnie Vlahos
on behalf of the CARE 1 Investigators
Publication date
01-04-2020
Publisher
Springer International Publishing
Published in
American Journal of Clinical Dermatology / Issue 2/2020
Print ISSN: 1175-0561
Electronic ISSN: 1179-1888
DOI
https://doi.org/10.1007/s40257-020-00510-6

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