1. Home
  2. Staquis
  3. Atopic Dermatitis

Atopic Dermatitis

Overview

Introduction
Staquis® is the first non-steroidal, topical, phosphodiesterase 4 (PDE4) inhibitor indicated for topical treatment of mild to moderate atopic dermatitis in adult and pediatric patients 3 months of age and older.1

AD is a common chronic inflammatory skin condition characterized by skin barrier disruption and immune system abnormalities.10

Mechanism of disease

Mechanism of disease AD is associated with excess production of proinflammatory cytokines.10
The production of some cytokines is regulated by PDE4, which is often overactive in cells (such as the leukocytes) of patients with AD.4


Overactive PDE4 increases the degradation of cyclic adenosine monophosphate (cAMP) to AMP, which leads to the overproduction of proinflammatory cytokines.3,5

Unmet need

Over 80% of children with AD have symptoms which continue into adulthood.2
Despite many patients living with the condition for years,2 adherence to topical AD treatments is often poor and might decreases over time.6

Topical treatments are commonly prescribed to alleviate symptoms, reduce inflammation and minimise exacerbation.2
The American treatment recommendation from 2023 (AAD) treatment guidelines currently recommend the use of topical corticosteroids (TCS), topical calcineurin inhibitors (TCI), or PDE4 inhibitors in mild-moderate disease.2,8

Despite their efficacy, both TCS and TCI are associated with limitations such as application site reactions and safety concerns with long-term application.
Some factors that should be considered when prescribing TCS include avoiding local cutaneous atrophy, treatable body surface area and sensitive skin regions.2

Understanding and evaluating AD

AD is chronic and a pruritic inflammatory skin condition that can affect both children and adults, with up to 90% of all patients presenting with a mild-to-moderate form of the disease.2

The Investigator’s Static Global Assessment (ISGA)‡ scale is a 5-point scale that can be used to assess the overall disease severity across all treatable lesions.2


ISGA scale Illustration† ISGA scale definitions
ISGA Grade 4:

Severe

ISGA


Deep/bright red erythema with severe induration/papulation, with oozing/crusting.2
ISGA Grade 3:

Moderate

ISGA


Pink-red erythema with moderate induration/papulation, with or without oozing/crusting.2
ISGA Grade 2:

Mild

ISGA


Faint pink erythema with mild induration/papulation, with or without oozing/crusting.2
ISGA Grade 1:

Almost Clear

ISGA


Trace faint pink erythema with barely perceptible induration/papulation and no oozing/crusting.2
ISGA Grade 0:

Clear

ISGA


Minor residual hypo/hyperpigmentation, no erythema or induration/papulation and no oozing/crusting.2

†Not an actual patient; images for illustrative purposes only.

‡ISGA Grade 4 patients were excluded from Staquis® clinical trials.2

AD symptoms, such as pruritus, can also contribute to significant psychological, social and quality of life (QoL) burdens for both patients and caregivers.2,9

Footnotes:
The specific mechanism(s) by which Staquis® exerts its therapeutic action is not well defined.1

Not an actual patient; for illustrative purposes only.

References

  1. Staquis® (crisaborole) latest approved prescribing information.
  2. Paller A, Tom W et al. J Am Acad Dermatol 2016;75(3):494–503.e6.
  3. Hanifin J, Chan S et al. J Invest Dermatol 1996;107(1):51–56.
  4. Chan S, Reifsnyder D et al. J Allergy Clin Immunol 1993;91(6):1179–1188.
  5. Jarnagin K, Chanda S et al. J Drugs Dermatol 2016;15(4):390–396.
  6. Tan X, Feldman S et al. Expert Opin Drug Deliv 2012;9(10):1263–1271.
  7. Fenerty S, O’Neill J et al. JAMA Dermatol 2013;149(2):229–231.
  8. Boguniewicz M, Fonacier L et al. Ann Allergy Asthma Immunol 2018;120(1):10–22.
  9. Yosipovich G, Simpson E et al. Itch 2018;3(2):e12.
  10. Bieber T. Atopic dermatitis. N Engl J Med. 2008;358(14):1483-1494