Apremilast, an oral phosphodiesterase-4 inhibitor, in the treatment of palmoplantar psoriasis: Results of a pooled analysis from phase II PSOR-005 and phase III Efficacy and Safety Trial Evaluating the Effects of Apremilast in Psoriasis (ESTEEM) clinical trials in patients with moderate to severe psoriasis

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• 作者：Robert Bissonnette ; MD^a ; ^{rbissonnette@innovaderm.ca" class="auth_mail" title="E-mail the corresponding author} ; David M. Pariser ; MD^b ; Norman R. Wasel ; MD ; FRCPC^c ; Joana Goncalves ; MD^d ; Robert M. Day ; PhD^d ; Rongdean Chen ; PhD^d ; Michael Sebastian ; MD^e
• 关键词：apremilast ; difficult to treat ; ESTEEM ; moderate to severe ; palmoplantar psoriasis ; palms ; PSOR-005 ; soles
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：75
• 期：1
• 页码：99-105
• 全文大小：766 K

文摘

Difficult-to-treat palmoplantar psoriasis has a disproportionately negative impact on quality of life.

Objective

We evaluated the efficacy and safety of apremilast in palmoplantar psoriasis.

Methods

A post hoc analysis of data pooled from phase IIb (PSOR-005) and phase III (Efficacy and Safety Trial Evaluating the Effects of Apremilast in Psoriasis [ESTEEM] 1 and 2) clinical studies was conducted to determine the effect of apremilast 30 mg twice daily versus placebo at week 16 in a subset of patients with moderate to severe plaque psoriasis with active palmoplantar psoriasis (baseline Palmoplantar Psoriasis Physician Global Assessment [PPPGA] score ≥1).

Results

Significantly more patients taking apremilast with moderate to severe palmoplantar psoriasis (baseline PPPGA score ≥3) achieved PPPGA score 0 (clear) or 1 (almost clear) compared with placebo at week 16 (48% vs 27%; P = .021). At week 16, 46% of the apremilast group with baseline PPPGA score 1 or higher achieved a PPPGA score of 0 versus 25% of the placebo group (P < .001); 59% of the apremilast group had a PPPGA score of 0 or 1 with 1-point or more improvement versus 39% receiving placebo (P < .001).

Limitations

This post hoc analysis was limited to 16 weeks and did not assess palmoplantar pustules, lesion localization, or surface area involvement.

Conclusion

Apremilast may be a useful oral treatment option for patients with moderate to severe palmoplantar plaque psoriasis.