Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 16.06.2023

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PDE4 inhibitor; phosphodiesterase 4 inhibitor

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Oral thalidomide analog(phosphodiesterase-4 inhibitor) developed by Celegene for the indications spondylitis, psoriatic arthritis or psoriasis arthropathica, and moderate to severe psoriasis vulgaris (S3 guideline). A small monocentric study is available for lichen planus. Others for Behcet's disease and rheumatoid arthritis and atopic eczema. In the phase III study (ESTEEM), patients with moderate to severe psoriasis were treated with 2x30mg/day apremilast for 52 weeks. At week 16, 28.8% of those treated achieved a PASI-75 response (5.8% with placebo).

Good success can be achieved with 2x30mg/day apremilast in psoriasis capitis as well as in nail psoriasis (LAPIS-PSO study - cited in Reich K et al. 2016/2018).

Apremilast has also been used successfully in lichen planus of the nails (Skullerud KH et al 2021) .

Field of application/use
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Moderate to severe psoriasis vulgaris and psoriatic arthritis. Apremilast was approved in mid-January 2015.

see also under folliculitis decalvans

Undesirable effects
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Diarrhoea, nausea, headache, upper respiratory tract infections.

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Otezla (Celgene)

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  1. De Souza A et al (2012) Apremilast for discoid lupus erythematosus: results of a phase 2, open-label, single-arm, pilot study. J Drugs Dermatol 11:1224-1226
  2. Gottlieb AB et al (2008) An open-label, single-arm pilot study in patients with severe plaque-type psoriasis treated with an oral anti-inflammatory agent, apremilast. Curr Med Res Opin 24:1529-1538.
  3. Paul J et al (2012) An open-label pilot study of apremilast for the treatment of moderate to severe lichen planus: A case series. J Am Acad Dermatol PubMed PMID: 22910104.
  4. Reich K et al. (2016) Annual meeting of the Austrian Society of Dermatology and Venereology (ÖGDV), Vienna, lecture FV 10.
  5. Reich K et al. (2018) Annual Meeting of the American Academy of Dermatology(AAD), February 18-20, 2018, San Diego , USA, poster 7104.
  6. Samrao A et al (2012) A pilot study of an oral phosphodiesterase inhibitor (apremilast) for atopic dermatitis in adults. Arch Dermatol 148:890-897
  7. Skullerud KH et al (2021) Apremilast for genital erosive lichen planus in women (the AP-GELP Study): study protocol for a randomised placebo-controlled clinical trial. Trials 22:469.


Last updated on: 16.06.2023