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In the atopic dermatitis market, topical therapies have been the mainstay of treatment, especially for patients with a mild to moderate form of the disease. Conventional systemic immunosuppressants such as azathioprine and cyclosporine are largely used in moderate to severe patients whose disease is inadequately controlled. With the launch of two novel therapies, Pfizer’s topical PDE-4 inhibitor Eucrisa (crisaborole) and Sanofi/Regeneron’s IL-4/IL-13 inhibitor Dupixent (dupilumab), the treatment landscape of atopic dermatitis is changing in the United States. Eucrisa, the first nonsteroidal topical to become available in more than a decade, provides a much-needed alternative to topical corticosteroids and topical calcineurin inhibitors. On the other hand, Dupixent should give moderate to severe atopic dermatitis patients a promising targeted therapy option, with AstraZeneca/Leo Pharma’s tralokinumab and Roche/Galderma’s lebrikizumab potentially strengthening the field in the near future. The entry of a premium-priced topical treatment, Eucrisa, and the first biologic therapy, Dupixent, will inevitably introduce access barriers into a previously genericized market as payers start to manage utilization to control costs.

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