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Eucrisa for Psoriasis: What We Know

Posted on March 18, 2021
Medically reviewed by
Kevin Berman, M.D., Ph.D.
Article written by
Erik Linklater, Ph.D.

Have you tried managing your psoriasis with common treatments such as hydrocortisone, biologics, or phototherapy, but had little success? If so, you may wonder about off-label treatments like Eucrisa.

What Is Eucrisa?

Eucrisa (crisaborole) is a small chemical compound made by Pfizer that was approved by the United States Food and Drug Administration (FDA) in 2016 for treating the symptoms of eczema, or atopic dermatitis, in people 2 years of age and older. It is prescribed as a 2 percent topical ointment that is applied twice daily. It has been shown to be effective in relieving itch and clearing skin. The most commonly reported side effects are a stinging or burning sensation at the site of application, which can be alleviated by the use of moisturizer along with the Eucrisa.

In contrast to corticosteroids, such as cortisone and prednisone, Eucrisa is a nonsteroidal chemical compound. It is an inhibitor protein called phosphodiesterase-4 (PDE-4). PDE-4 is known to moderate the immune system, a contributing factor to psoriasis and a common target for medications used to manage inflammatory-based conditions such as psoriasis. Because it does not contain a steroid, Eucrisa does not thin out the skin after prolonged use, making it an attractive option for chronic skin issues.

Off-Label Eucrisa Usage

There are many treatment options for people with psoriasis, such as over-the-counter moisturizers, corticosteroids, and calcineurin inhibitors. Despite this growing list of treatments, some people still have little success finding symptom relief, and others experience intolerable side effects. Because of the overlapping features of eczema and psoriasis, there is growing interest in Eucrisa as a possible psoriasis treatment. The limited side effects of Eucrisa make it an attractive option for people who have problems taking other medications.

Is Eucrisa FDA-Approved for Psoriasis?

Eucrisa is currently approved by the FDA to treat eczema. However, it is sometimes prescribed “off-label” to treat psoriasis. Off-label drug prescription is a practice often used when:

  • Side effects make taking approved medications unreasonable.
  • Currently approved therapies are not effective.
  • Existing medications are cost prohibitive.

Always consult with your dermatologist or health care provider to determine which medications are best for your situation.

Does Eucrisa Help Psoriasis?

Eucrisa’s anti-inflammatory properties and demonstrably low risk of side effects make it an attractive option for treating skin diseases, such as psoriasis. Because Eucrisa is so new, there is limited research that details its effectiveness for other skin conditions. However, current results suggest that Eucrisa has potential as a treatment for psoriasis and other conditions.

Eucrisa as a topical ointment inhibits a protein called phosphodiesterase-4 (PDE4). Apremilast is an oral medication that also inhibits PDE4 and is approved for psoriasis and psoriatic arthritis, but not for atopic dermatitis.

Psoriasis Treatment With Eucrisa

There are currently a few small-scale reports of using Eucrisa for treating psoriasis.

One recent report looked at two individuals who had psoriasis. One person had tried several treatments without success. Each was prescribed Eucrisa, and each reported a drastic improvement in their condition within two weeks of treatment.

A second report detailed one woman who was unable to treat her palmoplantar pustulosis with standard medications due to various side effects. Three months of twice-daily Eucrisa use caused significant improvement in her condition with no adverse effects reported.

Another recent study was finished in early 2019. In that study, 21 people with psoriasis were given either ointment with Eucrisa or ointment without Eucrisa. After one month, the group receiving Eucrisa showed large improvements in their psoriasis, while the group receiving plain ointment showed little to no improvement. Two months of treatment led to even greater improvement, with 10 of 14 people showing total clearance of psoriasis lesions.

These results are promising, although it is important to remember these studies involved relatively few people. Further testing will be needed to prove the effectiveness of Eucrisa for psoriasis. The gold-standard test will be a placebo-controlled, double-blind study to assess the efficacy of Eucrisa for psoriasis.

Clinical Trials Using Eucrisa for Psoriasis Treatment

In addition to the small-scale studies mentioned above, four clinical trials have reported results for testing the safety and effectiveness of Eucrisa for treating plaque psoriasis.

In one short-term study from 2008, 35 men with mild to moderate psoriasis were enrolled. Participants were then instructed to treat one psoriasis plaque twice daily with ointment containing 5 percent Eucrisa and to treat a second comparable but separate plaque with ointment alone.

  • After one month, 70 percent of Eucrisa-treated plaques showed improvement compared with ointment treatment alone. In comparison, only 7 percent of ointment-treated plaques showed improvement.
  • Multiple methods to assess plaque severity were used, such as erythema (skin redness) and plaque elevation.
  • There was only one reported instance of minimal, adverse effects.

A similar trial studied 30 men. Those with mild to moderate plaque psoriasis treated one psoriasis plaque twice daily with ointment containing 5 percent Eucrisa and another plaque with ointment alone.

  • Within one month, 60 percent of Eucrisa-treated plaques showed improvement compared with ointment treatment, whereas only 3 percent of ointment-treated plaques improved.
  • After three months, about half the Eucrisa-treated plaques showed improvement compared with ointment alone, and about one-third of ointment-treated plaques improved.
  • About 25 percent of patients reported mild skin-related adverse effects.

A larger clinical study in 2011 enrolled 68 men and women, each with mild to moderate plaque psoriasis. Enrollees were then treated twice daily with 2 percent Eucrisa ointment or twice daily with ointment alone.

  • After three months, successful treatment — defined as clear or almost-clear plaques — occurred in about 17 percent of participants who used Eucrisa. There was a similar success rate of about 14 percent for those who used ointment alone.
  • The most common adverse effects reported with Eucrisa treatment were mild skin-related issues, such as itching, burning, and rash.

A fourth, more sophisticated trial, enrolled 145 men and women and compared both the dosage and daily usage of Eucrisa to ointment alone. Each participant had a history of mild to moderate plaque psoriasis. They were asked to treat one psoriasis plaque with Eucrisa ointment either once or twice a day and another plaque with ointment alone. The Eucrisa ointment formulation was either 0.5 percent or 2 percent.

  • After 42 days, psoriasis plaques treated with Eucrisa showed a larger decrease in severity when compared with ointment alone. This decrease in severity occurred with both once-daily and twice-daily treatment.
  • The most commonly reported side effect was itching, by 16 percent of those who used the 2 percent Eucrisa ointment twice a day.

What Do These Studies Tell Us?

These studies have different numbers of participants, use different ways to assess treatment outcome, and use variable dosages of medication. This makes direct comparisons of the studies difficult. More research will need to be done to properly evaluate the safety and the ability of Eucrisa to treat different types of psoriasis. However, there are some results that appear encouraging:

  • Short-term relief of psoriasis with Eucrisa treatment occurs for at least some individuals. Some have longer-term relief.
  • Eucrisa appears to be effective in treating multiple types of psoriasis.
  • Use of Eucrisa for psoriasis has been effective when other treatments have not.
  • The side effects associated with its use are generally rare and mild.

Will Eucrisa Benefit Me?

Some MyPsoriasisTeam members have had success using Eucrisa. One member wrote, “A combination of Otezla and then Eucrisa on stubborn spots has done the trick. I’m back to being active and enjoying my retirement!”

Another member reported, “I am currently fighting the coronavirus, and my psoriasis has been getting worse. I have it on the top of my feet and my scalp, and now it’s trying to spread on one side of my neck. I have been using Eucrisa and it has helped calm it down.”

Although some members have reported improved symptoms, there are currently no large-scale, long-term studies that evaluate the effectiveness of Eucrisa in treating psoriasis. Although there are some promising reports, there is no guarantee that Eucrisa will work for everyone. However, you may want to ask your doctor about Eucrisa as an off-label treatment for psoriasis if:

  • Other treatments have limited or no effectiveness.
  • Effective medications or therapies raise significant quality-of-life concerns.
  • Other treatments are cost-prohibitive.

Always consult your health care provider to receive the proper medical advice to determine the benefits and risks associated with various medications, including Eucrisa.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. On MyPsoriasisTeam, more than 89,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriasis.

Have you used Eucrisa to treat your psoriasis? Share your experience in the comments below, or start a conversation by posting on your Activities page.

All updates must be accompanied by text or a picture.
Kevin Berman, M.D., Ph.D. is a dermatologist at the Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Learn more about him here.
Erik Linklater, Ph.D. has a Ph.D. in molecular biology from the University of Colorado, where he is currently a postdoctoral researcher. Learn more about him here.

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