A new therapeutic for the treatment of moderate-to-severe plaque psoriasis: apremilast

SUMMARY

Psoriasis is a common, chronic, inflammatory skin disease. Being a life-long condition, a prolonged and safe control of the disease is needed. Current anti-psoriatic treatments show some limits in terms of tolerability and route of administration. Recently, a new oral small molecule, apremilast, has been approved for the treatment of patients with moderate-to-severe plaque psoriasis. Apremilast is a phosphodiesterase 4 (PDE4) inhibitor that regulates the transduction of intracellular signals, including pro-inflammatory and anti-inflammatory pathways. Because of the favorable safety profile and the oral route of administration, apremilast may represent a promising therapeutic target for moderate-to-severe psoriasis. In this review, we report an updated overview about clinical trials testing apremilast in the treatment of psoriasis and seek to provide comprehensive information about this anti-psoriatic drug and a future perspective of the therapeutic algorithm for psoriasis.

KEYWORDS:

• Psoriasis
• phosphodiesterase inhibitor
• small molecule
• apremilast
• otezla
• oral drug

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Key issues

• Psoriasis is a chronic inflammatory skin disease affecting 2–3% of worldwide population.

• Apremilast is an orally administered PDE4 inhibitor that showed anti-inflammatory and immunomodulating activities.

• It has been recently approved by the FDA at a dose of 30 mg b.i.d. for the treatment of adult patients with psoriasis.

• Apremilast efficacy data demonstrated an improvement in all the clinical parameters considered, namely: PASI score, sPGA, scPGA, DLQI, NAPSI, pruritus-VAS and PPPGA.

• Consistent data confirm that it represents an effective and safe therapeutic option for the treatment of psoriasis.