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Dermbits

How would you present the product profile of topical roflumilast to HCP colleagues who are reluctant due to poor prior experience with other PDE4 inhibitors?

Psoriasis

You. This is a very interesting question, because I have to confess, full confession here is that while this product, the topical reflummalast, was being developed, I honestly wasn't very interested in it. And in part it's because we, of course, already have a topical phosphodesterase four inhibitor in dermatology. That's chrisoborol, and I think Chrisoborol is fine. It's a good medicine. It has been a nice addition for certain patients, but it's brought with it some baggage. Right? It really does. It has the issue that it hasn't been extremely powerful for most of my patients. In fact, many of my patients felt like it didn't do very much at all. And of course, we crossed that with the fact that post marketing, now obviously in the trials for chrysoborol, it wasn't a very high number of people that experienced stinging and burning. But post marketing, a lot more of my patients did report that, some to the point where they wouldn't use it anymore. Now that, again, could be my particular demographic, the people that I'm seeing and so on. But I think that was not that unique of an experience. And when I've talked to other colleagues, they haven't had the greatest experience with topical PDE four inhibitors in the past. That being said, once it came to market, and once I was able to try a sample and give it to a few patients, I've really flipped around. I've turned to 180 on this because I find that not only am I getting an efficacy that is the next level up, something that I think is much more robust and much more meaningful for patients than I had seen in the past, but I'm also seeing a tolerability that is really, really reassuring. In fact, now I feel it's one of the most tolerable things that I give out. And that says something again, because I have kind of a unique group of patients. So that's my language. I want stuff that obviously works well, but it also has to be safe and tolerable, and it's that very difficult tightrope to navigate. And I think topical reflumalast has really done a beautiful job with that so far. And of course, I'm still learning. I've only been using it for a few months, but as my experience accrues and I keep getting follow ups, it shapes you. If patients say, I didn't care for this one, that one didn't work, that one stung and burn, you sort of move away from that. If patients say, hey, I really like that one. Can I get a refill? Can you make sure I have more of it? That actually encourages you. You really do change your practice style depending on that feedback. Especially if you're in the trenches every day talking to people that have unmet needs.