Apremilast for the treatment of palmo‐plantar non‐pustular psoriasis: A real‐life single‐center retrospective study

Abstract

Palmoplantar psoriasis (PP) is a type of psoriasis that involves the skin of the palms and soles and can present as hyperkeratotic, similar to the vulgaris psoriasis of the body. Apremilast, as an oral inhibitor of phosphodiesterase 4 (PDE4), is currently approved for the treatment of psoriatic arthritis and for moderate‐to‐severe psoriasis in adult patients who have not responded or have contraindications or do not tolerate other systemic treatments. We evaluated the efficacy and safety of apremilast in the treatment of non‐pustular palmo‐plantar psoriasis in a cohort of 12 patients. We found a clinical response of clear/almost clear palmoplantar psoriasis (PPPGA score 0/1) in 83.33% of our patients, at week 16. No significant safety issues were reported and none of our patients had to discontinue the drug.

Real-Life Effectiveness and Safety of Risankizumab in 131 Patients Affected by Moderate-to-Severe Plaque Psoriasis: A 52-Week Retrospective Study

“…Treatment of difficult-to-treat areas in psoriasis is still challenging [ 4 ]. In this study, we analyzed three groups of psoriatic patients, stratified on the baseline PASI and the presence or not of psoriasis in difficult areas: patients with PASI > 10 without any involvement of difficult areas, patients with PASI > 10 and at least one difficult area affected and patients with exclusive involvement of difficult-to-treat areas.…”

“…Most of the cases present as mild or moderate conditions, with the involvement of less than 10% of body surface area (BSA). Moderate-to-severe cases, with the involvement of sensitive areas or more than 10% of BSA, affect 20% of the patients [ 4 , 5 ].…”

Apremilast in Palmoplantar Psoriasis and Palmoplantar Pustulosis: A Systematic Review and Meta-analysis

“…A total of 12 publications investigated patients with PP treated with apremilast (APR) including four placebo (PBO)-controlled RCTs [ 11 , 12 , 14 – 16 ], two randomized methotrexate (MTX) comparative trials [ 19 , 20 ], four prospective/retrospective cohort studies [ 22 – 24 , 26 ], and two case series [ 27 , 29 ] (Table 1 ).…”

“…2019 [ 26 ] LAPIS-PSO Prospective cohort None 67 (28 with baseline PPPGA ≥ 3) PPPGA 0 or 1 (baseline PPPGA ≥ 1) (%): 62.7 and 71.7 (week 16 and 52) (full analysis set) Pavia et al . 2022 [ 24 ] Retrospective cohort None 12 (11 with baseline PPPGA ≥ 3) 90.9 (week 24) Ständer et al . 2020 [ 29 ] Case series None 6 (palmoplantar pustular psoriasis) PGA of 0 or 1 (%): 83.3 (week 4) PGA 0 or 1 (%): 100.0 (week 12) Aceituno-Madera et al .…”

“…LAPIS-PSO, a 52-week, multicenter, observational cohort study in Germany investigating apremilast treatment for PP [ 26 ], resulted in 62.7 and 71.7% of patients ( n = 67) achieving PPPGA 0 or 1 at weeks 16 and 52, respectively. A single-center retrospective cohort study by Pavia et al [ 24 ] showed 90.9% ( n = 12) of subjects with moderate to severe PP (baseline PPPGA ≥ 3) achieving clearance (PPPGA 0 or 1) after 24 weeks of apremilast treatment.…”