title: Apremilast: A Novel Drug for Treatment of Psoriasis and Psoriatic Arthritis.
abstract: OBJECTIVE
  To review the pharmacology, efficacy, and safety of apremilast and determine its role relative to other agents in the treatment of psoriasis and psoriatic arthritis.
  
  
  METHODS
  A PubMed search (1946 to December 2015) using the terms apremilast and CC-10004 was conducted to identify relevant articles.
  
  
  METHODS
  In vitro or in vivo evaluations of apremilast published in the English language were eligible for inclusion. Controlled clinical trials that involved psoriasis or psoriatic arthritis were selected for review.
  
  
  RESULTS
  Four trials were identified on the treatment of psoriasis. In those that involved doses of 30 mg twice daily, a significantly greater percentage of patients receiving apremilast (28.8% to 40.9%) compared with placebo (5.3% to 5.8%) achieved at least 75% improvement from baseline in Psoriasis Area and Severity Index score at 16 weeks. Two trials were identified on the treatment of psoriatic arthritis. In the one that involved a dose of 30 mg twice daily, a significantly greater percentage of patients receiving apremilast (38.1%) compared with placebo (19.0%) achieved the American College of Rheumatology criteria for 20% improvement at 16 weeks. In all trials, the drug had an acceptable safety profile, with the most common adverse effects of diarrhea, nausea, and headache.
  
  
  CONCLUSIONS
  Apremilast has a novel mechanism of action and is safe and effective for the management of psoriasis and psoriatic arthritis. At this time, apremilast should be reserved for patients unable to take disease-modifying antirheumatic drugs.
authors.affiliation: Midwestern University College of Pharmacy-Glendale, AZ, USA shaber@midwestern.edu.
authors.forename: Stacy L
authors.initials: SL
authors.lastname: Haber
authors.affiliation: Midwestern University College of Pharmacy-Glendale, AZ, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Hamilton
authors.affiliation: Midwestern University College of Pharmacy-Glendale, AZ, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Bank
authors.affiliation: Midwestern University College of Pharmacy-Glendale, AZ, USA.
authors.forename: Shi Yun
authors.initials: SY
authors.lastname: Leong
authors.affiliation: Midwestern University College of Pharmacy-Glendale, AZ, USA.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Pierce
mesh_terms: D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D015535:Arthritis, Psoriatic / Q000188:drug therapy*; D003967:Diarrhea / Q000139:chemically induced; D006261:Headache / Q000139:chemically induced; D006801:Humans; D009325:Nausea / Q000139:chemically induced; D011565:Psoriasis / Q000188:drug therapy*; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D013792:Thalidomide; C505730:apremilast
keywords: bone/joint disorders; clinical pharmacology; drug development and approval; literature evaluation; psoriasis