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Eucrisa vs Dupixent
Introduction
Eucrisa and Dupixent are two medications that can help manage symptoms of atopic dermatitis or eczema, a skin condition characterized by red, itchy rashes. These drugs operate differently within the body but both aim to control inflammation and reduce flare-ups. Eucrisa is a topical phosphodiesterase 4 inhibitor (PDE-4) applied directly on the affected areas; it works by adjusting levels of certain substances in the body that trigger inflammation. Dupixent, on the other hand, is an injectable monoclonal antibody which inhibits interleukin-4 (IL-4) and interleukin-13 (IL-13), cytokines known to play key roles in inflammatory responses. Both these medications have proven effective for many patients struggling with moderate-to-severe atopic dermatitis.
Eucrisa vs Dupixent Side By Side
| Attribute | Eucrisa | Dupixent |
|---|---|---|
| Brand Name | Eucrisa | Dupixent |
| Contraindications | Should not be used concurrently with immune suppressant drugs like cyclosporine or methotrexate due to potential drug interactions. | Should not be used concurrently with immune suppressant drugs like cyclosporine or methotrexate due to potential drug interactions. |
| Cost | $700 for a 60g tube | $3,000 for two injections (300 mg) |
| Generic Name | Crisaborole | Dupilumab |
| Most Serious Side Effect | Severe allergic reactions | Signs of an allergic reaction, vision problems |
| Severe Drug Interactions | Concurrent use with immune suppressant drugs | Concurrent use with immune suppressant drugs |
| Typical Dose | Applied twice daily as a thin layer to the affected areas | 600 mg loading dose, followed by 300mg every other week |
What is Eucrisa?
Crisaborole (the generic name for Eucrisa) is a non-steroidal topical medication that was first approved by the FDA in 2016. It represents a new class of targeted biologic therapies designed to treat atopic dermatitis (eczema). Eucrisa works by inhibiting an enzyme called phosphodiesterase-4, which reduces inflammation in the skin. Dupilumab (the brand name being Dupixent), on the other hand, is an injectable biologic drug that was also FDA-approved for treating moderate-to-severe eczema in adults and children aged six years or older. Unlike Eucrisa, Dupixent blocks two proteins — interleukin-4 and interleukin-13 — known to drive inflammation in the body. Both drugs have been shown to reduce itching and improve overall symptoms of eczema; however, they work through different pathways with differing side-effect profiles. For example, while potential side effects of Eucrisa include burning or stinging upon application, those associated with Dupixent can range from conjunctivitis and cold sores to more serious systemic reactions like hypersensitivity.
What conditions is Eucrisa approved to treat?
Eucrisa and Dupixent are both approved for the treatment of different forms of atopic dermatitis:
- Eucrisa (crisaborole) is a nonsteroidal topical medication used to treat mild to moderate atopic dermatitis, also known as eczema, in patients two years of age and older.
- Dupixent (dupilumab) is an injectable biologic drug used for treating moderate-to-severe atopic dermatitis in adults and adolescents aged 12 years or older whose disease cannot be adequately controlled with topical prescription therapies. It's also approved for use in children aged six years or older with moderate-to-severe atopic dermatitis who are not well controlled with topical prescription treatments.
How does Eucrisa help with these illnesses?
Eucrisa works to manage eczema by inhibiting an enzyme called phosphodiesterase-4 (PDE-4) in the skin. By blocking this enzyme, Eucrisa helps reduce inflammation and aids in managing and alleviating symptoms of atopic dermatitis, also known as eczema. PDE-4 is associated with inflammatory responses in the body and plays a significant role in triggering symptoms such as redness, itching, swelling, among others observed with eczema. Patients suffering from chronic conditions like eczema typically have higher levels of PDE-4 activity within their cells. Therefore, by limiting PDE-4 activity using Eucrisa, patients are able to mitigate inflammation caused due to overactive immune response thereby helping them manage their condition effectively.
What is Dupixent?
Dupixent, or dupilumab, is an injectable biologic medication that blocks the action of two proteins in your body — interleukin-4 and interleukin-13 — which contribute to inflammation in people with certain conditions. It was granted approval by the FDA in 2017. While Eucrisa (crisaborole) works as a topical phosphodiesterase 4 inhibitor applied on the skin, Dupixent functions differently by modulating your body’s immune response. This unique mode of action means that its side-effect profile also differs from that of other eczema treatments like Eucrisa; it doesn't cause local irritation at the site of application but can lead to potential systemic effects such as conjunctivitis and changes in blood eosinophil levels. The distinctive way Dupixent operates may be beneficial for treating moderate-to-severe eczema, especially in patients who have not seen improvement with topical medications such as Eucrisa.
What conditions is Dupixent approved to treat?
Dupixent is approved by the FDA for the treatment of several conditions, which include:
- Moderate to severe atopic dermatitis in patients aged 6 years and older who are not adequately controlled with topical prescription therapies or when those therapies are not advisable.
- Asthma of moderate-to-severe nature, with an eosinophilic phenotype or oral corticosteroid-dependent asthma in patients aged 12 years and older.
- Chronic rhinosinusitis characterized by nasal polyposis (CRSwNP) in adults.
How does Dupixent help with these illnesses?
Interleukin-4 and Interleukin-13 are proteins that, when overproduced in our body, can cause inflammation and play a significant role in chronic inflammatory conditions like eczema. Dupixent is an innovative medication that works by blocking these interleukins from binding to their receptors, thus reducing the inflammation associated with these conditions. Its action on this specific pathway makes it particularly effective for treating moderate-to-severe atopic dermatitis (eczema) where topical treatments such as Eucrisa have not provided adequate relief or are not advisable due to side effects. Since it does not significantly affect other immune responses, Dupixent may be prescribed when a patient has severe eczema or is unresponsive to typical topical treatments.
How effective are both Eucrisa and Dupixent?
Both crisaborole (Eucrisa) and dupilumab (Dupixent) have established histories of success in treating patients with moderate to severe atopic dermatitis, and they were initially approved by the FDA a few years apart. Crisaborole is a nonsteroidal topical medication that works by inhibiting an enzyme called phosphodiesterase-4, which can lead to reduced inflammation in the skin. On the other hand, Dupilumab is a biologic drug administered through injection that works by blocking proteins known as interleukins, which are involved in immune responses leading to inflammation.
The effectiveness of both Eucrisa and Dupixent has been demonstrated in numerous clinical trials. A 2016 double-blind study involving over 1500 participants aged 2 years or older showed that crisaborole was effective at reducing symptoms of eczema such as itching, redness, lichenification (thickened skin), and oozing after 28 days of treatment. In comparison, several studies on dupilumab have shown it to be highly effective for adults with moderate-to-severe atopic dermatitis who did not respond sufficiently to topical treatments.
A recent review highlighted that while both medications offer benefits for those suffering from atopic dermatitis; their different modes of administration may influence patient choice. While some individuals might prefer applying Eucrisa as a cream directly onto affected areas twice daily; others might find more convenience in using Dupixent's injectable form every other week despite its potential side effects like cold sores or eye inflammation.
It's important to note that while both drugs are promising options for managing atopic dermatitis; individual response will vary depending on various factors including severity of condition and overall health status among others.
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At what dose is Eucrisa typically prescribed?
Topical applications of Eucrisa (crisaborole) are generally used twice daily. The thin layer should be applied to the affected areas, and it is suitable for use on all skin types. It can be used by adults and children over two years old. On the other hand, Dupixent (dupilumab) is administered through a subcutaneous injection every other week after an initial loading dose. The standard dosage for adults is 300mg every two weeks, while adolescents aged 12-17 may start with a 200mg or 300mg dosage depending on their weight. In both scenarios, if there's no noticeable improvement within several weeks, medical consultation is necessary to adjust the treatment plan accordingly. Neither medication's maximum dose should be exceeded without medical supervision.
At what dose is Dupixent typically prescribed?
Dupixent treatment begins with a loading dose of 600 mg (two 300 mg injections), followed by 300mg given every other week via subcutaneous injection. This regimen is recommended for adults and adolescents aged 12 years or older. The Dupixent dosage can be self-administered, but it's essential to receive proper training from a healthcare provider before doing so. It's injected into the thigh or abdomen, away from the navel, or into the upper arm if administered by another person. If after several weeks there's no improvement in your symptoms, consult with your healthcare provider as an adjustment in your treatment plan may be necessary.
What are the most common side effects for Eucrisa?
Typical side effects of Eucrisa include:
- Application site reactions such as burning or stinging
- Erythema (redness)
- Pruritus (itching)
Whereas, Dupixent is often linked with:
- Injection site reactions
- Conjunctivitis and keratitis (eye inflammation)
- Cold sores in your mouth or on your lips
- Elevated eosinophil levels (type of white blood cell)
As these are both topical medications primarily for skin conditions such as eczema, many typical systemic side effects like anxiety, insomnia, nausea etc. are not commonly associated with their use. However, it's always important to be aware of potential allergic reactions when starting any new medication.
Are there any potential serious side effects for Eucrisa?
While Eucrisa and Dupixent are both used to treat eczema, they can cause different side effects. For instance:
- With Eucrisa, you might experience burning or stinging sensations at the application site.
- Severe allergic reactions aren't common but could occur. If you notice symptoms like hives; difficulty breathing; swelling of the face, lips, tongue or throat; seek immediate medical attention.
Dupixent on the other hand has its own set of potential side effects such as:
- Eye problems like dryness, redness, itching and inflammation which can lead to serious issues if not addressed promptly.
- Hypersensitivity reactions including fever, swollen lymph nodes or rash may also occur.
- Rarer still are instances of eosinophilic conditions involving various body systems.
Neither medication should result in mental health changes like increased thoughts about suicide/self-harm nor serotonin syndrome symptoms (agitation, hallucinations etc.) since these drugs do not affect serotonin levels in your brain. Always consult with a healthcare provider for personalized advice regarding medication choices.
What are the most common side effects for Dupixent?
Dupixent, often used for treating eczema and other skin conditions, may cause side effects that include:
- Conjunctivitis or eye redness
- Injection site reactions such as swelling or redness
- Generalized itching
- Cold sores in your mouth or on your lips
- Upper respiratory infections including sinusitis and pharyngitis
- Nausea
- Joint pain (arthralgia) Please note that this is not an exhaustive list and it's always recommended to consult with a healthcare professional should any concerns arise.
Are there any potential serious side effects for Dupixent?
While Dupixent is generally well-tolerated, it can also present with certain side effects. Some of these adverse reactions include:
- Signs of an allergic reaction: hives; difficulty breathing or swallowing, swelling in your face or throat.
- Vision problems: blurred vision, eye pain or redness, seeing halos around lights.
- Conjunctivitis and other eye-related complications such as dryness and itching
- Cold sores in your mouth or on your lips.
- Unusual changes in mood or behavior.
If any of these symptoms occur while using Dupixent, discontinue the medication immediately and seek medical advice promptly. Remember to always consult with a healthcare professional before starting new medications for proper guidance based on individual health history.
Contraindications for Eucrisa and Dupixent?
Both Eucrisa and Dupixent, along with most other eczema medications, may exacerbate symptoms of skin irritation in some people. If you notice your itching or redness worsening after using these medications, consult with a healthcare professional immediately.
Eucrisa and Dupixent should not be used concurrently if you are taking immune suppressant drugs like cyclosporine or methotrexate due to potential drug interactions that may lead to undesirable side effects. Always inform your physician about all the medicines you are currently taking; certain immunosuppressants might need some time to completely clear from your system before starting treatment with Eucrisa or Dupixent.
It's also worth noting that both Eucrisa and Dupixent can cause serious allergic reactions. If you experience any symptoms such as hives; difficult breathing; swelling of your face, lips, tongue, or throat while on these treatments, seek immediate medical attention.
How much do Eucrisa and Dupixent cost?
For the brand name versions of these drugs:
- The price of a 60g tube of Eucrisa (2% ointment) averages around $700, which works out to approximately $23/day, based on applying two grams per day.
- The cost for two injections of Dupixent (300 mg) is about $3,000, working out to around $50/day if administered every other week.
Thus, if you are using the recommended dose for Eucrisa and Dupixent as eczema treatments, then brand-name Eucrisa is less expensive on a per-day treatment basis. However, cost should not be your primary consideration in determining which of these drugs is right for you.
Currently there are no generic versions available for either Eucrisa or Dupixent due to patent protection. Therefore their costs remain high compared to most generic medications.
Popularity of Eucrisa and Dupixent
Crisaborole, available as the brand-name Eucrisa, is a non-steroidal topical medication used for mild to moderate atopic dermatitis (eczema) in patients two years of age and older. In 2020, it was estimated that approximately 1 million prescriptions were written for Crisaborole in the United States.
Dupilumab, marketed under the brand name Dupixent, is an injection-based treatment approved for use in adults and children aged six years or older with moderate to severe eczema who are candidates for systemic therapy. It has also been approved to treat other allergic conditions such as asthma and chronic rhinosinusitis with nasal polyposis. Approximately 650 thousand individuals received prescriptions for Dupilumab in the US during 2020.
Despite being administered differently – one topically and one by injection - both drugs target inflammation that's thought to contribute to eczema symptoms. Though less commonly prescribed than Eucrisa, Dupixent can be used when topical treatments aren't enough or not appropriate due its more systemic nature.
Conclusion
Both Eucrisa (crisaborole) and Dupixent (dupilumab) have been approved by the FDA for use in patients with atopic dermatitis, often known as eczema, with multiple clinical trials indicating their efficacy over placebo treatments. In certain cases, these drugs may be used together but this should be under careful supervision of a healthcare professional due to potential interaction side effects. Their different mechanisms of action mean they are typically prescribed under different circumstances: Eucrisa works by blocking an enzyme called phosphodiesterase-4 which can lead to inflammation in the body, while Dupixent targets two proteins that are key drivers of the persistent underlying inflammation that occurs in atopic dermatitis.
Eucrisa is applied directly on the skin and is available as a topical ointment making it suitable even for children aged 2 years old and above; whereas Dupixent is administered via subcutaneous injection usually given every two weeks after initial loading doses, thus generally preferred for moderate-to-severe eczema not controlled adequately by topical therapies or when those therapies are not advisable.
In terms of cost-effectiveness, both drugs can be expensive especially if paid out-of-pocket although generic alternatives are currently unavailable. Both medications require time to show noticeable improvements on your skin condition.
Side effects vary between these two medications - common side effects for Eucrisa include application site pain or burning sensation whilst Dupixent might cause eye problems like dry eyes and conjunctivitis among others. For both medications, any worsening symptoms should prompt immediate medical attention.
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Refrences
- Hoy, S. M. (2017, October 26). Crisaborole Ointment 2%: A Review in Mild to Moderate Atopic Dermatitis. American Journal of Clinical Dermatology. Springer Science and Business Media LLC.http://doi.org/10.1007/s40257-017-0327-4
- Clark, R., Bozkaya, D., Levenberg, M., Faulkner, S., Smith, T. W., & Gerber, R. A. (2018, May 21). Topical treatment utilization for patients with atopic dermatitis in the United States, and budget impact analysis of crisaborole ointment, 2%. Journal of Medical Economics. Informa UK Limited.http://doi.org/10.1080/13696998.2018.1470520
- Shirley, M. (2017, May 25). Dupilumab: First Global Approval. Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40265-017-0768-3
- Makins, C., Sanghera, R., & Grewal, P. S. (2020, March 5). Off-Label Therapeutic Potential of Crisaborole. Journal of Cutaneous Medicine and Surgery. SAGE Publications.http://doi.org/10.1177/1203475420909794