title: Apremilast for the treatment of psoriasis.
abstract: BACKGROUND
  Psoriasis is a chronic inflammatory skin disease characterized by dysregulation of the immune system and release of pro-inflammatory mediators. Drugs available for psoriasis show some limits as tolerability and route of administration. Apremilast , Otezla®, is an oral small molecule recently approved for the treatment of patients with moderate-to-severe plaque psoriasis. Compared to biologics that target a single cytokine, apremilast, degrading phosphodiesterase 4 (PDE4), interferes with cyclic anti-microbial peptides, which is involved in the transduction of intracellular signals, controlling the balance of pro-inflammatory and anti-inflammatory signals.
  
  
  METHODS
  This review reported the latest data available from Phase I, II and III trials on apremilast for the treatment of plaque psoriasis. A focus on the clinical management of apremilast, safety and clinical efficacy based on two pivotal clinical trials (ESTEEM 1 and ESTEEM 2) currently ongoing was described. A systematic search was conducted using the PubMed Medline database for primary articles.
  
  
  CONCLUSIONS
  Apremilast treatment was demonstrated effective and well tolerated in Phase II and III clinical trials. Several drug peculiarities, such as the low frequency of adverse events and the oral route of administration, make apremilast an innovative treatment for moderate-to-severe psoriasis.
authors.affiliation: University of Rome "Tor Vergata", Rheumatology, Allergology and Clinical Immunology , Rome , Italy.
authors.forename: Maria Sole
authors.initials: MS
authors.lastname: Chimenti
authors.forename: Talia
authors.initials: T
authors.lastname: Gramiccia
authors.forename: Rosita
authors.initials: R
authors.lastname: Saraceno
authors.forename: Luca
authors.initials: L
authors.lastname: Bianchi
authors.forename: Virginia
authors.initials: V
authors.lastname: Garofalo
authors.forename: Oreste
authors.initials: O
authors.lastname: Buonomo
authors.forename: Roberto
authors.initials: R
authors.lastname: Perricone
authors.forename: Sergio
authors.initials: S
authors.lastname: Chimenti
authors.forename: Andrea
authors.initials: A
authors.lastname: Chiricozzi
mesh_terms: D000284:Administration, Oral; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D058988:Phosphodiesterase 4 Inhibitors / Q000627:therapeutic use*; D011565:Psoriasis / Q000188:drug therapy*; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D058988:Phosphodiesterase 4 Inhibitors; D013792:Thalidomide; C505730:apremilast
keywords: Otezla®; apremilast; biological therapy; phosphodiesterase 4; psoriasis; small molecule