Patient leaflet - Staquis
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4.2 Posology and method of administration
Posology
Adults
A layer of ointment is to be applied twice daily to affected areas.
The ointment should only be applied to affected skin areas up to a maximum of 40% BSA.
The ointment can be used on all skin areas except on the scalp. Use on the scalp has not been studied.
The ointment can be used twice daily for up to 4 weeks per treatment course. If any signs and/or symptoms persist, or new areas affected with atopic dermatitis appear, further treatment course(s) can be used as long as the application does not exceed 40% BSA (see section 5.1).
Use of the ointment should be discontinued if signs and/or symptoms on treated areas persist after 3 consecutive treatment courses of 4 weeks each or if the signs and/or symptoms worsen during treatment.
Paediatric population
For children and adolescents (2–17 years) the posology is the same as for adults.
The safety and efficacy of Staquis in children less than 2 years of age has not been established. No data are available.
Special populations
Hepatic impairment
Clinical studies in subjects with hepatic impairment have not been conducted. However, dosage adjustment is not expected to be necessary in subjects with mild to moderate hepatic impairment
Renal impairment
Clinical studies in subjects with renal impairment have not been conducted. However, adjustment is not expected to be necessary in this patient population.
Elderly
Atopic dermatitis is uncommonly observed in patients aged 65 years and over. Clinical studies of Staquis did not include sufficient numbers of subjects aged 65 years and over to determine whether they respond differently from younger subjects (see section 5.1). However, dosage adjustment is not expected to be necessary in this patient population.
Method of administration
The ointment is for cutaneous use only.
The ointment is not for ophthalmic, oral, or intravaginal use (see section 4.4).
Staquis has not been specifically studied under occlusion. However, clinical experience available for use of the ointment under occlusion (i.e., nappies or clothing) has not shown the necessity for any dosage adjustment.
Patients should be instructed to wash their hands after applying the ointment, unless it is their hands that are being treated. If someone else applies the ointment to the patient, they too should wash their hands after application.
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4.3 Contraindicatio
Hypersensitivity t
4.4 Speci
tive substance or to any of the excipients listed in section 6.1.
ngs and precautions for use
The ointment is not for ophthalmic, oral, or intravaginal use (see section 4.2). In cases of accidental exposure in the eyes or mucous membranes, the ointment should be thoroughly wiped off and/or rinsed with water.
Available data indicate that local skin reactions, such as burning or stinging, may be more likely to occur on sensitive skin areas (such as the face and neck).
Hypersensitivity
Hypersensitivity, including contact urticaria, has occurred in patients treated with Staquis.
Hypersensitivity should be suspected in the event of severe pruritus, swelling and erythema at the application site or at a distant site. If signs and symptoms of hypersensitivity occur, Staquis should be discontinued immediately and appropriate therapy should be initiated.
Excipients with known effect
This medicine contains 90 mg propylene glycol in each gram of ointment.
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4.5 Interaction with other medicinal products and other forms of interaction
Neither crisaborole nor its two main metabolites are expected to cause drug interactions by induction or inhibition of cytochrome P450 (CYP) enzymes based on in vitro and in vivo data (see section 5.2).
Based on in vitro data, concomitant administration of Staquis and CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, erythromycin, clarithromycin, ritonavir) or CYP1A2 inhibitors (e.g., ciprofloxacin, fluvoxamine) can increase systemic crisaborole concentrations (see section 5.2).
Staquis has not been evaluated in combination with other cutaneous medicinal products used to treat mild to moderate atopic dermatitis and co-application on the same skin areas is not recommended. Emollients may be used on other areas of skin not affected by atopic dermatitis; co-application of emollients with Staquis on the same skin areas is not recommended.
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4.6 Fertility, pregnancy and lactation
Pregnancy
There are no or limited amount of data from the use of crisaborole in pregnant women. Animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity (see section 5.3). As a precautionary measure, it is preferable to avoid the use of Staquis during pregnancy.
Breast-feeding
milk following topical application of the oi
lack of clinical data during breast-feedin breastfed infant. Therefore, because of th should not be used in breast-feeding wo
Animal studies on milk excretion after topical application were not conducted. Staquis is systemically absorbed. It is unknown whether crisaborole or its metabolites or excipients are excreted in human tment or has an effect on human milk production. The recludes a clear determination of the risk of Staquis to a otential for adverse reactions in breastfed infants, Staquis
Fertility
v X
Reproduction studies in male or female rats using oral administration of crisaborole revealed no
Reproduction studies in male or female rats using ora effects on fertility (see section 5.3).
4.7 Effects on ability to drive and use machines
Staquis
or negligible influence on the ability to drive and use machines.
4.
desirable effects
Summary of the safety profile
The most common adverse reactions are application site reactions (6.0%), including application site pain, e.g., burning or stinging (4.4%). Generally, application site pain was noted early in the treatment period and was transient in nature, resolving spontaneously.
Tabulated list of adverse reactions
Adverse reactions are ranked under headings of frequency, with the most frequent first, using the following convention: very common (> 1/10); common (> 1/100 to < 1/10); uncommon (> 1/1,000 to < 1/100); rare (> 1/10,000 to < 1/1,000); very rare (< 1/10,000); not known (cannot be estimated from the available data).
Table 1: Adverse reactions
Immune system disorders | |
Uncommon | Hypersensitivity |
Skin and subcutaneous tissue disorders | |
Uncommon | Urticaria contact |
General disorders and administration site cone | itions |
Common | Application site reactions (e.g., application site pain1, application site pruritus, application site dermatitis, application site erythema, application site irritation, application site urticaria) |
1 Refers to skin sensations such as burning or stinging.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the national reporting system listed in
4.9 Overdose
Overdose following cutaneous administration is unlikely. If too much of the ointment has been applied, the excess can be wiped off.
In cases of accidental ophthalmic, oral mucosa, or intravaginal exposure, the ointment should be thoroughly wiped off and/or rinsed with water (see sections 4.2 and 4.4).
5. PHARMACOLOGICAL PROPERTIES
5.1 Pharmacodynamic properties
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Pharmacotherapeutic group: Other dermatological preparations, agents for dermatitis, excluding corticosteroids, ATC code: D11AH06
Mechanism of action
Crisaborole is an anti-inflammatory benzoxaborole phosphodiesterase-4 (PDE4) inhibitor that suppresses secretion of certain cytokines, such as tumour necrosis factor-a (TNF-a), interleukins (IL-2, IL-4, IL-5), and interferon gamma (IFNy), and improves skin barrier function as measured by transepidermal water loss (TEWL). Crisaborole applied on atopic dermatitis lesions of patients reduces expression of atopic inflammation associated chemokines including CCL17, CCL18, and CCL22.
Clinical efficacy and safety
Two multicentre, randomised, double-blind, parallel-group, vehicle-controlled trials (Trials 1 and 2), identical in design, included a total of 1,522 subjects 2 to 79 years of age. 61.9% of subjects were 2–11 years old, 24.4% of subjects were 12–17 years old, 13.3% of subjects were 18–64 years old, and 0.5% of subjects were 65 years of age or older; the number of subjects > 18 years of age was limited. The treatable BSA ranged from 5% to 95% (mean = 18.3%, standard deviation [SD] = 17.8%; 9.6% of subjects had > 40% treatable BSA); the trials did not include sufficient numbers of subjects with > 40% treatable BSA to determine the safety and efficacy of Staquis in this subpopulation. At baseline (pooled study data), 38.5% of the subjects had an Investigator’s Static Global Assessment (ISGA) score of 2 (Mild), and 61.5% had an ISGA score of 3 (Moderate), in the overall assessment of atopic dermatitis (erythema, induration/papulation, and oozing/crusting) on a severity scale of 0 to 4.
In both trials, subjects were randomised 2:1 to receive Staquis or vehicle applied twice daily for 28 days. The primary efficacy endpoint was the proportion of subjects at Day 29 who achieved an ISGA grade of Clear (score of 0) or Almost Clear (score of 1) with at least a 2-grade improvement from baseline, comparing Staquis-treated subjects to vehicle-treated subjects. In both trials, a statistically significantly greater percentage of subjects achieved this endpoint in the Staquis-treated group compared with the vehicle-treated group.
The secondary efficacy endpoints were the proportion of subjects at Day 29 with an ISGA grade of
Clear or Almost Clear and the time to achieve an ISGA grade of Clear or Almost Clear with at l 2-grade improvement from baseline.
The safety and efficacy of Staquis on sensitive skin areas (such as the face and neck) compared to nonsensitive skin areas (such as the arms and legs) were not separately assessed in the clinical trials.
Efficacy results from the two trials are summarised in Tables 2 and 3. The Kaplan-Meier plots for the time to achieve an ISGA score of Clear or Almost Clear with at least a 2-grade improvement from baseline are provided in Figures 1 and 2. The log-rank test p-values for both trials were < 0.001.
Table 2: Efficacy outcomes in subjects with mild to moderate ato]
ISGA score of Clear or Almost Clear with at least a 2-grade improvement from baseline at
Day 29
95% CIa ________________
p-value
ISGA of Clear or Almost Clear at Day 29
Trial 1
Staquis (N = 503)
(28.6, 37.0)
25.4% (19.9, 30.9)
ipic dermatitis
>> Trial 2
Staquis (N = 513)
31.4% (27.3, 35.5)
Vehicle (N = 250)
18.0%
(13.2, 22.9)
95% CIa ________
p-value
0.038b
(47.2, 56.1)
40.6% (34.4, 46.8)
0.005b
< 0.001b
48.5% (44.1, 52.9)
29.7% (23.9, 35.5)
< 0.001b
approximation.
h Firth option) test with factors of treatment group and analysis centre after
a Confidence Interval (CI) b p-value from a logistic re adjusted for multiple imp
Table 3: Post-hoc efficacy outcomes in subjects with mild to moderate atopic dermatitis with
< 40% BSA affected
Trial 1 | Trial 2 | |||
Staquis (N = 446) | Vehicle (N = 231) | Staquis (N = 465) | Vehicle (N = 234) | |
ISGA score of Clear or Almost Clear with at least a 2-grade improvement from baseline at Day 29 | 34.1% | 25.5% | 32.6% | 18.8% |
95% CIa | (29.7, 38.6) | (19.7, 31.3) | (28.3, 36.9) | (13.7, 24.0) |
p-value | 0.022b | <0.0001b | ||
ISGA of Clear or Almost Clear at Day 29 | 53.8% | 41.9% | 51.0% | |
95% CIa | (49.1, 58.5) | (35.3, 48.4) | (46.4, 55.6) | (24.8, 37.0) |
p-value | 0.0041b | <0.000 | 1b |
a Confidence Interval (CI) from normal approximation.
b p-value from a logistic regression (with Firth option) test with factors of treatment group and analysis centre after adjusted for multiple imputation.
Trial 1
100–
¡3 t>
90–
80–
70–
60–
50–
- % –8
40–
30–
20–
10–
Figure 1: Kaplan-Meier plot of Time to ISGA score of Clear or Almost Clear with at least a 2-grade improvement from baseline for subjects with mild to moderate atopic dermatitis
E
Í.2 o ~ I !
? $
0–
aq»iis (N=503)
ehicle (N=256)
Days Alter Dosmg
Censor:
° Staquis
D Vehicle
Trial 2
P-value fam Log-Rank Test: <.001
i e e p
y o £ < O
i----------1----------1-----------1-----------1-----------1-----------1-----------1-----------1-----------1----------1-----------1-----------1-----------1----------1-----------1-----------1----------1-----------1-----------1----------1-----------1-----------1----------1----------1----------r—i-----------r
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 22^17 28 29
Treatment Group: --------Staquis (N=513) ---Vehicle (N=250)
Days After Dosing
Censor:
° Staquis
□ Vehicle
Figure 2: Post-hoc Kaplan-Meier plot of Time to ISGA score of Clear or Almost Clear with at least a 2-grade improvement from baseline for subjects with mild to moderate atopic dermatitis with < 40% BSA affected
Trial 1
80–
60-
50-
30–
20-
0-
Days After Dosing
° Staquis
□ Vehicle
Jg J
I 1 g
o ê
£i g-
8 “
S?
0
Trial 2
100 -
90-
80-
70-
60-
50 -
30 -
20 -
10-
6
Treatment Group:
------ Staqiiis (N=465)
– – Vehicle (N-234)
2 3 4
27 28 29
8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
Days After Dosing
Censor:
0
n Vehicle
The pooled primary efficacy results by race category are summarised i
e 4.
Almost Clear with at least a – Trial 1 and 2 pooled
Native Hawaiian or Other Pacific Islander
Other
N = Nu n = Num
52
Asian
White
Black or African American
285
32.1%
42.9%
33.5%
31.9%
617
44
subjects in each treatment group
subjects in each sub-group category by treatment group
27
139
306
21
13.4%
24.6%
17.0%
22.3%
16.3%
Table 4: Summary of subjects achieving ISGA score of 2-grade improvement from baseline at Day 29 by race c
Staquis (N = 1016) | Vehicle (N = 506) | ||
Race Category | n Rate | n Rate |
18.0%
0.0%
11
5
American
Indian or Alaska Native
One multicentre, single-arm, open-label long-term safety trial (Trial 3) included a total of 517 subjects 2 to 72 years of age (59.6% of subjects were 2–11 years old, 28.2% of subjects were 12–17 years old, 11.8% of subjects were 18–64 years old, and 0.4% of subjects were 65 years of age or older) with a 5% to 95% treatable BSA. Subjects at participating investigator sites (a subset of sites that participated in Trials 1 and 2) who completed Trials 1 or 2 without safety events that precluded further treatment with Staquis were eligible.
Subjects participated in the study in 28-day treatment courses for up to 48 weeks. Subjects received Staquis for a variable number of treatment courses intermittently based on disease severity as determined by the ISGA at the beginning of each 28-day treatment course: subjects received open-label treatment with Staquis twice daily (on-treatment when ISGA was Mild or worse [> 2]) or no treatment (off-treatment when the ISGA was Clear [0] or Almost Clear [1]). Discontinuation from the study was to occur if there was no improvement in the subject’s ISGA after 3 consecutive treatment courses of treatment with Staquis.
Trial 3 did not include an efficacy endpoint; Staquis efficacy response based on ISGA determined the extent of intermittent use of Staquis for up to 48 weeks. Overall, subjects received a mean of 6.2 on-treatment courses (out of a possible 13 on-treatment courses including the 28-day treatment period in Trials 1 or 2). The mean number of consecutive on-treatment courses was 3.6 and the mean number of consecutive off-treatment courses was 2.5.
QT study results
Results from a thorough QT study of Staquis applied to 60% BSA in healthy volunteers did not demonstrate QT prolongation. Although healthy volunteers had lower crisaborole concentrations compared to patients with atopic dermatitis, clinical studies of Staquis did not identify any cardiac effects including prolongation of QT interval.
Paediatric population
The European Medicines Agency has deferred the obligation to submit the results of studies with Staquis in one or more subsets of the paediatric population for the treatment of atopic dermatitis (see section 4.2 for information on paediatric use).
5.2 Pharmacokinetic properties
Absorption
The pharmacokinetics (PK) of Staquis were investig with mild to moderate atopic dermatitis and a mean
to 92%). In this study, subjects applied approxim approximately 6 g to 30 g per application) twice
in 33 paediatric subjects 2 to 17 years of age BSA involvement of 49 ± 20% (range 27% mg/cm2 of Staquis ointment (dose range was
quantifiable in all subjects. The mean ± SD concentration time curve from 0 to 12 hour 196 ng/mL and 949 ± 1240 ng*h/mL, respe
ily for 8 days. Plasma concentrations were
steady state by Day 8. Based on accumulation factor for crisabor its main metabolites increased w
maximum plasma concentration (Cmax) and area under the s post dose (AUC0–12) for crisaborole on Day 8 were 127 ± ctively. Systemic concentrations of crisaborole were at f AUC0–12 between Day 8 and Day 1, the mean
as 1.9. Systemic exposure (Cmax and AUC0–12) of crisaborole and ncreasing % BSA treated.
The studies were performed with a different formulation of crisaborole which, unlike Staquis, contained butylhydroxytoluene (BHT). In vitro permeation testing (IVPT) was performed in intact skin to support therapeutic equivalence between the BHT-containing and the no-added BHT formulations. ugh the results were inconclusive and highly variable, a possible slight increase in
permeation is xpected to influence the benefit-risk profile of the product in patients with up to
40% BSA affected to a clinically relevant extent.
Distribution
Based on an in vitro study, crisaborole is 97% bound to human plasma proteins.
Biotransformation and elimination
Crisaborole is substantially metabolised into inactive metabolites. The main metabolite 5-(4-cyanophenoxy)-2-hydroxyl benzylalcohol (metabolite 1), is formed via multiple CYP enzymes including CYP3A4, 1A2 and hydrolysis; this metabolite is further metabolised into downstream metabolites, among which 5-(4-cyanophenoxy)-2-hydroxyl benzoic acid (metabolite 2), formed via oxidation, is also a main metabolite. PK of metabolites 1 and 2 were assessed in the PK study described above and the systemic concentrations were at or near steady state by Day 8. Based on the ratios of AUC0–12 between Day 8 and Day 1, the mean accumulation factors for metabolites 1 and 2 were 1.7 and 6.3, respectively. The mean ± SD Cmax and AUC0–12 for metabolite 2 on Day 8 were 1850 ± 1830 ng/mL and 18200 ± 18100 ng*h/mL, respectively. Renal excretion of metabolites is the major route of elimination. Approximately 25% of the radiolabelled dose was absorbed and predominantly excreted in the urine.
Drug interactions
Potential for crisaborole to influence the PK of other medicinal products
In vitro studies using human liver microsomes indicated that under the conditions of clinical use, crisaborole and metabolite 1 are not expected to inhibit CYP1A2, 2B6, 2C8, 2C9, 2C19, and 3A4.
In vitro human liver microsomes studies for metabolite 2 showed that it did not inhibit activities of CYP2C19, 2D6, and 3A4; was a weak inhibitor of CYP1A2 and 2B6; and a moderate inhibitor of CYP2C8 and 2C9. The most sensitive enzyme, CYP2C9, was further investigated in a clinical trial using warfarin as a CYP2C9 substrate. The results of this study showed no drug interaction potential.
In vitro studies indicate that under the condition of clinical use, crisaborole and metabolites 1 and 2 are not expected to induce CYP enzymes.
Based on in vitro data, crisaborole is metabolised to some extent (<30%) via CYP3A4 and CYP1A2. Concomitant administration of Staquis and potent CYP3A4 or CYP1A2 inhibitors may result in increases in crisaborole systemic exposure.
In vitro studies showed that crisaborole and metabolite 1 did not inhibit the activities of uridine diphosphate (UDP)-glucuronosyltransferase (UGT) 1A1, 1A4, 1A6, 1A9, 2B7, and 2B15. Metabolite
2 did not inhibit UGT1A4, 1A6, 2B7, and 2B15. Meta however, no clinically significant drug interactions are metabolites) and UGT1A1 substrates at therapeutic co
inhibition of UGT1A9 and may result in a mode UGT1A9 substrates, such as propofol. A clinical
bolite 2 showed weak inhibition of UGT1A1; expected between crisaborole (and its ncentrations. Metabolite 2 showed moderate crease of the concentrations of sensitive
relevant interaction between metabolite 2 and
propofol is not anticipated due to the posology and method of administration of propofol (intravenous infusion or injection with titration to clinical effect for anaesthesia or sedation). Drug interaction studies with sensitive UGT1A9 substrates have not been conducted.
In vitro studies indicate that under the condition of clinical use, crisaborole and metabolites 1 and 2 are not expected to cause clinically significant interactions with substrates of transporters such as P-glycoprotein, breast cancer resistance protein (BCRP) and organic anionic or cationic transporters.
5.3 Preclinical
data
Preclini adminis pharma deve
om studies conducted in vitro or in vivo by the oral and dermal routes of eal no special hazard for humans based on conventional studies of safety
, repeated-dose toxicity, genotoxicity, juvenile toxicity, or toxicity to reproduction and
A drug-related increased incidence of benign granular cell tumours in the uterus with cervix and vagina (combined) was noted in crisaborole-treated female rats at oral doses approximately 2 times the mean human systemic exposure in maximum use conditions. The clinical relevance of this finding is unknown, however given the tumour type and benign status in a single species and single sex, the relevance to humans is considered to be low.
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6. PHARMACEUTICAL PARTICULARS
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6.1 List of excipients
Paraffin, white soft
Propylene glycol (E 1520)
Glycerol monostearate 40–55 (Type I)
Paraffin, hard
Sodium calcium edetate
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6.2 Incompatibilities
Not applicable.
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6.3 Shelf life
3 years.
After first opening the container: 1 year.
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6.4 Special precautions for storage
Do not store above 25 °C. Do not freeze.
Keep the tube tightly closed.
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6.5 Nature and contents of container
Multi-layered laminate tube with a high density polyethylene tube head with a peel seal, and a white
polypropylene cap closure. The exterior
ube consists of seven layers (low-density
polyethylene, white high-density polyethylene, high-density polyethylene, low-density polyethylene ethylene-acrylic acid, foil, and ethylene-acrylic acid). The inner lining consists of linear low-density polyethylene.
Tubes of 2.5 g, 30 g, 60 g, and 100 g. Six tubes per carton for the 2.5 g tubes. One tube per carton for the 30 g, 60 g, and 100 g tubes.
Not all tube sizes may b
ted.
6.6 Special pre
s for disposal
Any unused medicinal product or waste material should be disposed of in accordance with local requirements.
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7. MARKETING AUTHORISATION HOLDER
Pfizer Europe MA EEIG Boulevard de la Plaine 17 1050 Bruxelles
Belgium
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8. MARKETING AUTHORISATION NUMBER(S)
EU/1/19/1421/001
EU/1/19/1421/002
EU/1/19/1421/003
EU/1/19/1421/004
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9. DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION
Date of first authorisation: 27 March 2020
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10. DATE OF REVISION OF THE TEXT
Detailed information on this medicinal product is available on the website of the European Medicines Agency
A.
ANNEX II
MANUFACTURER RESPONSIBL
ATCH RELEASE
B.
C.
CONDITIONS OR RESTRICTIONS REGARDING SUPPLY AND USE
OTHER CONDITIONS AND REQUIREMENTS OF THE MARKETING AUTHORISATION
D.
CONDITIO THE SAFE
STRICTIONS WITH REGARD TO FFECTIVE USE OF THE MEDICINAL
A. MANUFACTURER RESPONSIBLE FOR BATCH RELEASE
Name and address of the manufacturer responsible for batch release
Pfizer Service Company BVBA
Hoge Wei 10
1930 Zaventem
Belgium
B. CONDITIONS OR RESTRICTIONS REGARDING SUPPLY AND USE
Medicinal product subject to medical prescription.
C. OTHER CONDITIONS AND REQUIREMENTS OF THE MARKETING AUTHORISATION
Periodic safety update reports (PSURs)
The requirements for submission of PSURs for this medicinal pro Union reference dates (EURD list) provided for under Article 107 and any subsequent updates published on the European medicines
The marketing authorisation holder (MAH) shall submit the 6 months following authorisation.
et out in the list of rective 2001/83/EC
R for this product within
D. CONDITIONS OR RESTRICTIONS WITH REGARD TO THE SAFE AND
EFFECTIVE USE OF THE MEDICI
RODUCT
Risk management plan (RMP)
The marketing authorisation holder
shall perform the required pharmacovigilance
activities and interventions deta led in the agreed RMP presented in Module 1.8.2 of the marketing authorisation and any agreed subsequent updates of the RMP.
dated RMP should be submitted:
At the request of the European Medicines Agency;
Whenever the risk management system is modified, especially as the result of new information being received that may lead to a significant change to the benefit/risk profile or as the result of an i rtant (pharmacovigilance or risk minimisation) milestone being reached.
PARTICULARS TO APPEAR ON THE OUTER PACKAGING
OUTER CARTON (2.5 g, 30 g, 60 g, 100 g)
1. NAME OF THE MEDICINAL PRODUCT
Staquis 20 mg/g ointment crisaborole
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7. OTHER SPECIAL WARNING(S), IF NECESSARY
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8. EXPIRY DATE
EXP
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9. SPECIAL STORAGE CONDITIONS
Do not store above 25 °C. Do not freeze.
Keep the tube tightly closed.
Staquis
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17. UNIQUE IDENTIFIER – 2D BARCODE 2D barcode carrying the unique identifier included.
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18. UNIQUE IDENTIFIER – HUMAN READABLE DATA
PC
SN
NN
TUBE (30 g, 60 g, 100 g)
1. NAME OF THE MEDICINAL PRODUCT
Staquis 20 mg/g ointment crisaborole
7. OTHER SPECIAL WARNING(S), IF NECESSARY
8. EXPIRY DATE
EXP
-
9. SPECIAL STORAGE CONDITIONS
Do not store above 25 °C. Do not freeze.
Keep the tube tightly closed.
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10. SPECIAL PRECAUTIONS FOR DISPOSAL OF UNUSED MEDICINAL PRODUCTS OR WASTE MATERIALS DERIVED FROM SUCH MEDICINAL PRODUCTS, IF APPROPRIATE
Lot
14. GENERAL CLASSIFICATIO
SUPPLY
15. INSTRUCTIONS
16. INFOR
N IN BRAILLE
17
IQUE IDENTIFIER – 2D BARCODE
18. UNIQUE IDENTIFIER – HUMAN READABLE DATA
TUBE (2.5 g)
1. NAME OF THE MEDICINAL PRODUCT AND ROUTE(S) OF ADMINISTRATION
Staquis 20 mg/g ointment crisaborole
Cutaneous use
Package leaflet: Information for the patient
Staquis 20 mg/g ointment
crisaborole
This medicine is subject to additional monitoring. This will allow quick identification of new safety information. You can help by reporting any side effects you may get. See the end of section 4 for how to report side effects.
Read all of this leaflet carefully before you start using this medicine because it contains important information for you.
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– Keep this leaflet. You may need to read it again.
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– If you have any further questions, ask your doctor, pharmacist, or nurse.
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– This medicine has been prescribed for you only. Do not pass it on to others. It may harm them,
even if their signs of illness are the same as yours.
-
– If you get any side effects, talk to your doctor, pharmacist, or nurse. This includes any possible
side effects not listed in this leaflet. See section 4.
What is in this leaflet
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1. What Staquis is and what it is used for
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2. What you need to know before you use Staquis
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3. How to use Staquis
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4. Possible side effects
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5. How to store Staquis
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6. Contents of the pack and other information
1. What Staquis is and what it is used for
Staquis contains the active substance crisaborole. Staquis is used on the skin to control the symptoms of mild to moderate atopic dermatitis in adults and children from 2 years of age. Atopic dermatitis, also called atopic eczema, causes skin inflammation, redness, itchiness, dryness, and thickening in people prone to allergies. The ointment should not be used on more than 40% of your body surface area.
Crisaborole, the active substance in Staquis, is thought to work by reducing inflammation and some effects of the immune system (the body’s defences).
2. What you need to know before you use StaquisDo not use Staquis- if you are allergic to crisaborole or any of the other ingredients of this medicine (listed in
section 6).
Warnings and precautions
Talk to your doctor or pharmacist before using Staquis.
Staquis is not for use in the eyes, mouth, or vagina; therefore, take care not to get this ointment into these areas. If the ointment accidentally gets into these areas, thoroughly wipe off and/or rinse off the ointment with water.
Stop using Staquis immediately and see your doctor if you get an allergic reaction. Symptoms include welts (hives), itching, swelling, and redness that are severe.
Skin reactions where this medicine is applied, such as burning or stinging, may be more likely to occur on sensitive skin areas such as the face and neck.
Children
Staquis has not been studied in children younger than 2 years of age; therefore, it should not be used in this group of children. Speak to your doctor, pharmacist, or nurse.
Other medicines and Staquis
Tell your doctor or pharmacist if you are using, have recently used or might use any other medicines.
Some medicines can affect the levels of Staquis in your body. You should inform your doctor if you are taking medicines containing the following active substances:
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– ketoconazole, itraconazole (used to treat fungal infections)
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– erythromycin, clarithromycin, ciprofloxacin (used to treat infections)
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– ritonavir (used to treat HIV)
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– fluvoxamine (used to treat depression).
Pregnancy and breast-feeding
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before using this medicine. The effects of this medicine in pregnant women are not known; therefore, do not use Staquis in pregnancy unless you have checked with your doctor that you can use it.
It is not known if Staquis passes into the milk after applying it to the skin. The effects of this medicine in breastfed infants are not known; therefore, Staquis should not be used if you are breast-feeding or are planning to breast-feed.
Driving and using machines
Staquis is unlikely to have an effect on your ability to drive and use machines.
Staquis contains propylene glycol
in each gram of ointment.
This medicine contains 90 mg propylene
3. How to use Staquis
Always use this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
Use in adults
-
– Apply a layer of the ointment twice daily to affected areas of your skin.
-
– This medicine can be used on all skin areas except on the scalp.
-
– The ointment should only be used on up to 40% of your body surface area.
Wash your hands after applying this medicine, unless it is your hands that are being treated. If someone else applies this medicine to you, they should wash their hands after application.
This medicine can be used twice daily for up to 4 weeks per treatment course. As instructed by your doctor, you can use further treatment course(s) if your atopic dermatitis is not controlled or appears on new areas as long as you do not apply the ointment to more than 40% of your body surface area. If your atopic dermatitis is still there after 12 weeks of therapy, or if your atopic dermatitis gets worse, stop using the medicine and see your doctor.
Moisturisers (emollients) may be used on areas of the skin where Staquis is not applied. Do not use other topical medicines (such as ointments, creams, lotions) on areas of the skin where Staquis is applied without asking your doctor.
Use in children and adolescents
For children 2 years of age and older, and adolescents the instructions for use are the same as for adults.
If you use more Staquis than you should
If too much Staquis has been applied, the excess should be wiped off.
If you forget to use Staquis
If you forget to apply the ointment at the scheduled time, do it as soon as you remember and then continue your normal dosing schedule.
If you have any further questions on the use of this medicine, ask your doctor, pharmacist, or nurse.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Allergic reactions may occur uncommonly. Allergic reactions include severe
ms of:
-
– hives
-
– itching
-
– swelling
-
– redness.
y and talk with your doctor or
If you have an allergic reaction, stop using this medicine im pharmacist.
Other side effects may include:
Common (may affect up to 1 in 10 people)
-
– Skin reactions where this medicine is applied such as pain (burning or stinging), itching, rash, redness, irritation, and hives.
5. How to store Staquis
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the tube and carton after “EXP”. The expiry date refers to the last day of that month.
Do not store above 25 °C. Do not freeze.
Once opened, use the tube within 1 year.
Keep the tube tightly closed.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6. Contents of the pack and other information
What Staquis contains
– The active substance is crisaborole.
One g of ointment contains 20 mg of crisaborole.
The other ingredients are paraffin, white soft; propylene glycol (E 1520 [see section 2]); glycerol monostearate 40–55 (Type I); paraffin, hard; sodium calcium edetate.
What Staquis looks like and contents of the pack
Staquis is a white to off-white ointment. It is supplied in 2.5 g, 30 g, 60 g, and 100 g laminate tubes. There are six tubes per carton for the 2.5 g tubes. There is one tube per carton for the 30 g, 60 g, and 100 g tubes. Not all tube sizes may be marketed.
Each tube comes with a tube head with a peel seal, and a white cap closure.
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This leaflet was last revised in
Detailed information on this medicine is available on the European Medicines Agency web site: http : //www.ema.europa.eu.
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