Comparison of psoriasis guidelines for use of apremilast in the United States and Europe: a critical appraisal and comprehensive review

Abstract

Purpose

This review article serves to compare global dermatologic organizations and the available clinical practice guidelines for the use of apremilast in the treatment of psoriasis.

Materials and methods

Guidelines from the American Academy of Dermatology (AAD), the National Psoriasis Foundation (NPF), the European S3, the National Institute for Health and Care Excellence (NICE), the French Society of Dermatology (SFD), the Swiss S1, and Italy were reviewed and compared.

Results

Of the American and European guidelines available for use of apremilast, several organizations are in agreement regarding the dosage of apremilast, but there are significant disagreements concerning matters such as medication indication, pretreatment laboratory testing, and contraindications to therapy.

Conclusion

Apremilast is an effective and well-tolerated treatment option for patients with psoriasis and should be considered in the line of therapy that dermatologists discuss with their patients, especially those with contraindications to other systemic therapies such as biologics. Consideration should be given to the evidence-based recommendations of global dermatology organizations to help guide therapeutic decisions.

Keywords:

• Apremilast
• clinical practice guidelines
• phosphodiesterase 4 inhibitor
• psoriasis

Disclosure statement

Dr. Wu is or has been an investigator for AbbVie, Amgen, Eli Lilly, Janssen, Novartis; a consultant for AbbVie, Almirall, Amgen, Bristol-Myers Squibb, Celgene, Dermira, Dr. Reddy’s Laboratories, Eli Lilly, Janssen, LEO Pharma, Novartis, Promius Pharma, Regeneron, Sun Pharmaceutical, and UCB, Valeant Pharmaceuticals North America LLC; and a speaker for AbbVie, Celgene, Novartis, Regeneron, Sanofi Genzyme, Sun Pharmaceutical, UCB, Valeant Pharmaceuticals North America LLC. Ms. Ghamrawi and Dr. Ghiam do not have any potential conflicts of interest.