APREMILAST

By Gary M. White, MD


Note: This is a summary only. Please consult the latest information when prescribing.

Indications for Adults 18 Years of Age or Older

Mechanism of Action

Inhibits PDE4 but full mechanism of action is not fully understood.

Efficacy in Psoriasis

Trade Name in US

Otezla

Dosing

Warnings and Precautions

Depression occurred in 1.3% of patients on Otezla compared with 0.4% of patients on placebo.

Adverse Reactions (Otezla %, placebo %)

Pregnancy Category

C

Atopic Dermatitis

There is some interest and some data that apremilast can improve atopic dermatitis. [Arch Dermatol. 2012 Aug;148(8):890-7].

Multiple Lentigines

Multiple lentigines have occurred in patients with psoriasis treated with apremilast (in this report, a total of 5) [JAAD 2016;75;1251]. All cases occurred in the first four months of treatment only on psoriatic lesions that had regressed. None of the patients received phototherapy, and lentigines appeared in most cases in sun-protected areas. Lentigines were still present five years after their occurrence.

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