title: 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.
abstract: BACKGROUND
  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).
  
  
  CONCLUSIONS
  This post hoc analysis was limited to 16 weeks and did not assess palmoplantar pustules, lesion localization, or surface area involvement.
  
  
  CONCLUSIONS
  Apremilast may be a useful oral treatment option for patients with moderate to severe palmoplantar plaque psoriasis.
authors.affiliation: Innovaderm Research Inc, Montreal, Quebec, Canada. Electronic address: rbissonnette@innovaderm.ca.
authors.forename: Robert
authors.initials: R
authors.lastname: Bissonnette
authors.affiliation: Eastern Virginia Medical School and Virginia Clinical Research Inc, Norfolk, Virginia.
authors.forename: David M
authors.initials: DM
authors.lastname: Pariser
authors.affiliation: Probity Medical Research and Stratica Medical, Edmonton, Alberta, Canada.
authors.forename: Norman R
authors.initials: NR
authors.lastname: Wasel
authors.affiliation: Celgene Corporation, Summit, New Jersey.
authors.forename: Joana
authors.initials: J
authors.lastname: Goncalves
authors.affiliation: Celgene Corporation, Summit, New Jersey.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Day
authors.affiliation: Celgene Corporation, Summit, New Jersey.
authors.forename: Rongdean
authors.initials: R
authors.lastname: Chen
authors.affiliation: Gemeinschaftspraxis Mahlow, Mahlow, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Sebastian
mesh_terms: D000284:Administration, Oral; D000328:Adult; D004311:Double-Blind Method; D005260:Female; D005533:Foot Dermatoses / Q000188:drug therapy* / Q000473:pathology; D006229:Hand Dermatoses / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D058988:Phosphodiesterase 4 Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology; D012720:Severity of Illness Index; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D058988:Phosphodiesterase 4 Inhibitors; D013792:Thalidomide; C505730:apremilast
keywords: ESTEEM; PSOR-005; apremilast; difficult to treat; moderate to severe; palmoplantar psoriasis; palms; soles