Apremilast in the Treatment of Plaque Psoriasis: Differential Use in Psoriasis

Jia C Gao,1 Albert G Wu,1 Marissa N Contento,1 Jacqueline M Maher,1 Abigail Cline2 1School of Medicine, New York Medical College, Valhalla, NY, USA; 2Department of Dermatology, New York Medical College, New York, NY, USACorrespondence: Abigail Cline, Department of Dermatology, New York Medical College, 1901 First Avenue, New York, NY, 10029, USA, Tel +1 212 423-6262, Email clinea@nychhc.orgAbstract: Small molecule medications like apremilast are emerging as promising options for patients with psoriasis and other inflammatory conditions. Apremilast was approved by the Food and Drug Administration in 2014 for the management of both psoriasis and psoriatic arthritis. Apremilast inhibits phosphodiesterase-4, which increases the intracellular levels of cyclic AMP, thereby reducing inflammatory cytokine production. This review aims to discuss the published evidence and evaluate the differential use of apremilast in plaque psoriasis of the body and scalp, nail psoriasis, and palmoplantar psoriasis. In clinical trials, apremilast effectively reduced the severity of different dermatological manifestations of psoriasis and improved patients’ quality of life. It has an acceptable safety profile and is generally well-tolerated. Oral medications like apremilast offer an alternative route of administration which can be more convenient and appropriate for some patients. Additionally, pharmacoeconomic analyses of available anti-psoriatic systemic agents favor apremilast as a cost-effective therapeutic option.Keywords: apremilast, efficacy, phosphodiesterase inhibitor, small molecule, plaque psoriasis, safety, scalp, nail, palmoplantar, systemic, biologic, cost-efficacy, pharmacoeconomics