Comparing the Efficacy of Roflumilast and Crisaborole

Panelists discuss how topical PDE4 inhibitors compare to traditional treatments like corticosteroids in terms of efficacy, safety, and long-term disease control, while also examining the unique formulations of roflumilast and crisaborole and their implications for skin penetration and patient experience; they highlight practical considerations for application, the management of adverse effects such as stinging and burning, and the distinct advantages of PDE4 inhibitors in addressing specific gaps in atopic dermatitis management for various patient subgroups.

EP: 1.Evolution of Topical Treatment for AD

EP: 2.PDE4 Inhibitor Roflumilast for AD

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EP: 3.Comparing the Efficacy of Roflumilast and Crisaborole

EP: 4.Roflumilast: Mechanism, and Use for Proactive AD Management

1. In your opinion, how do topical PDE4 inhibitors compare with traditional treatments like topical corticosteroids in terms of efficacy, safety, and long-term disease control?
   1. Please comment on how you use steroids vs nonsteroidal treatments like PDE4 inhibitors in the treatment of atopic dermatitis. (please discuss patient types)
2. Can you describe the unique aspects of the formulations of roflumilast and crisaborole? How might these differences affect skin penetration, bioavailability, and overall patient experience? [Stein Gold, 2024][Paller, 2016]
   1. Based on clinical trial data and your experience, how would you compare the efficacy and tolerability of roflumilast and crisaborole in treating atopic dermatitis?
   2. Please discuss the opportunity that roflumilast has as a new PDE4 in treating atopic dermatitis.
3. What are the practical considerations when applying PDE4s to different locations on the body, and how do you manage any location-specific adverse effects or challenges?
4. Crisaborole has been associated with stinging and burning sensations. What contributes to these adverse effects, and how does roflumilast’s formulation address them?
   1. How might these differences impact patient experience and adherence?
5. What makes PDE4s particularly noteworthy in the broader landscape of topical treatments? Are there unique attributes that set them apart, and what gaps in atopic dermatitis management do they address?
   1. Please discuss what separates PDE4 inhibitors from other nonsteroidal treatment options for atopic dermatitis
   2. In your opinion, which patient subgroups might benefit most from these treatments?
6. How should clinicians consider the long-term use of PDE4 inhibitors in atopic dermatitis? [Stein Gold, 2024][Lebwohl, 2020]
   1. What are the potential concerns or benefits of chronic management?

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