title: Pharmacodynamic assessment of apremilast for the treatment of moderate-to-severe plaque psoriasis.
abstract: BACKGROUND
  Psoriasis is a chronic inflammatory skin disease affecting 2-3% of the population. Certain systemic drugs currently available for its treatment could be associated, in the long term, with organ toxicity and adverse events, thus, clinical monitoring throughout treatment is required. Moreover, tolerability issues, parenteral administration, and barriers to patient access, such as high cost and specialist management lead to treatment failure.
  
  
  METHODS
  Apremilast is an oral small molecule inhibitor of phosphodiesterase 4 (PDE4i). PDE is the major enzyme class responsible for the hydrolysis of cyclic adenosine monophosphate in immune cells (cAMP). With PDE4 inhibition, apremilast works intracellularly to modulate pro-inflammatory and anti-inflammatory mediator production critically involved in psoriasis. The aim of this paper is to focus the attention on apremilast pharmacodynamics effects, its efficacy and safety in treating moderate-to-severe plaque psoriasis.
  
  
  CONCLUSIONS
  Apremilast is an effective and well-tolerated option in treating moderate-to-severe plaque psoriasis. Its safety profile and the oral administration offer significant advantages in prescribing apremilast for the treatment of psoriasis, particularly in some subsets of patients.
authors.affiliation: a Department of Systems Medicine, Division of Dermatology , University of Rome Tor Vergata , Rome , Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Bianchi
authors.affiliation: a Department of Systems Medicine, Division of Dermatology , University of Rome Tor Vergata , Rome , Italy.
authors.forename: Ester
authors.initials: E
authors.lastname: Del Duca
authors.affiliation: b Division of Dermatology, Department of Clinical and Experimental Medicine , University of Pisa , Pisa , Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Romanelli
authors.affiliation: a Department of Systems Medicine, Division of Dermatology , University of Rome Tor Vergata , Rome , Italy.
authors.forename: Rosita
authors.initials: R
authors.lastname: Saraceno
authors.affiliation: a Department of Systems Medicine, Division of Dermatology , University of Rome Tor Vergata , Rome , Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Chimenti
authors.affiliation: b Division of Dermatology, Department of Clinical and Experimental Medicine , University of Pisa , Pisa , Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Chiricozzi
mesh_terms: D000284:Administration, Oral; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000473:pathology; D018836:Inflammation Mediators / Q000378:metabolism; D058988:Phosphodiesterase 4 Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology; D012720:Severity of Illness Index; D013792:Thalidomide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D018836:Inflammation Mediators; D058988:Phosphodiesterase 4 Inhibitors; D013792:Thalidomide; C505730:apremilast
keywords: Apremilast; oral therapy; phosphodiesterase-4-inhibitor; psoriasis; small molecule