Pilot Study Evaluating the Efficacy of a Topical PDE4 Inhibitor for Morphea

A Phase 2, pilot, proof-of-concept, open label, single arm prospective study to assess the
safety, tolerability and efficacy of using crisaborole 2% ointment for adult morphea.
Patients identified by their physician, nurse, or other member of their clinical care team as
meeting criteria for the study will be asked to apply crisaborole 2% ointment, twice daily,
on affected plaques for 12 weeks. A 4 mm skin punch biopsy will be performed at baseline and
at 12 weeks, on the same affected plaque. Dermal thickness will be measured and compared
before and at the end of treatment. Patients will have a clinical assessment at baseline and
at weeks 4, 8 and 12. After week 12, patients who need further treatment will undergo
standard of care treatment as determined by their primary dermatologist. Physician and
patient reported assessment and skin imaging will be performed at baseline, week 4, 8 and 12,
and at week 20. Photography will also be performed at baseline and week 12. An optional post
treatment follow-up will be performed at week 20.

Medication will be provided free of charge by Pfizer, as part of the grant that is funding
this study. These will be dispensed by the study group at baseline and during the subsequent
clinic visits.

Inclusion Criteria:

1. >= 18 years of age

2. Clinical diagnosis of morphea.

3. <20% Total body surface area involvement.

4. Does not require systemic immunosuppressive therapy for morphea.

5. No immunosuppressive systemic therapy 1 month prior to starting the study
(methotrexate, mycophenolate mofetil, azathioprine, cyclosporine, cyclophosphamide,
prednisone >=10 mg PO daily).

6. No immunomodulating topical therapy (topical steroids or topical calcineurin
inhibitor), and no topical vitamin D analogue, 2 weeks prior to starting study.

7. No allergy to crisaborole or vehicle.

8. No known renal disease

9. Able to give informed consent.

Exclusion Criteria:Subjects fulfilling any of the following criteria are not eligible for
inclusion in this study.

1. Clinical diagnosis of depression or history of suicidal ideation.

2. Pregnant or breastfeeding women, with pregnant women being defined as the state of a
female after conception until the termination of gestation, confirmed by a positive
urine human chorionic gonadotropin (hCG) laboratory test. Women with a positive urine
hCG at any time during the study will be withdrawn from the study.