Crisaborole 2% ointment for the treatment of intertriginous, anogenital, and facial psoriasis: A double-blind, randomized, vehicle-controlled trial

J Am Acad Dermatol. 2020 Feb;82(2):360-365. doi: 10.1016/j.jaad.2019.06.1288. Epub 2019 Jul 3.

Abstract

Background: Psoriasis of the intertriginous, anogenital, and facial regions remains a therapeutic challenge, with current algorithms lacking a topical agent that exhibits both high efficacy and minimal side effects.

Objective: To assess the safety and efficacy of crisaborole 2% ointment-a nonsteroidal phosphodiesterase 4 inhibitor-in the treatment of intertriginous, anogenital, and facial psoriasis.

Methods: A double-blind, randomized, vehicle-controlled trial was conducted in 21 participants. Participants were randomized 2:1 to receive 4 weeks of twice-daily treatment with either crisaborole 2% ointment (n = 14) or vehicle ointment (n = 7), followed by 4 weeks of open-label treatment with crisaborole 2% ointment. Disease severity was measured by using the Target Lesion Severity Scale (TLSS).

Results: After 4 weeks, participants in the crisaborole group demonstrated 66% improvement compared with 9% in the vehicle group (P = .0011). Participants in the crisaborole group continued to experience improvement through the open-label phase, demonstrating 81% lesional improvement by week 8, with 71% of these participants achieving clinical clearance. There were no adverse events.

Limitations: The study was limited to a single tertiary care center and small sample size.

Conclusion: Treatment with crisaborole 2% ointment was well-tolerated and led to clinical improvement in participants with intertriginous, anogenital, or facial psoriasis.

Keywords: PDE-4 inhibitor; crisaborole; facial psoriasis; genital psoriasis; intertriginous psoriasis; inverse psoriasis.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anal Canal
  • Boron Compounds / administration & dosage*
  • Boron Compounds / adverse effects
  • Bridged Bicyclo Compounds, Heterocyclic / administration & dosage*
  • Bridged Bicyclo Compounds, Heterocyclic / adverse effects
  • Double-Blind Method
  • Facial Dermatoses / drug therapy
  • Female
  • Genitalia
  • Humans
  • Male
  • Middle Aged
  • Ointments
  • Pharmaceutical Vehicles
  • Psoriasis / drug therapy*
  • Treatment Outcome

Substances

  • Boron Compounds
  • Bridged Bicyclo Compounds, Heterocyclic
  • Ointments
  • Pharmaceutical Vehicles
  • crisaborole