Off-label studies on apremilast in dermatology: a review

Abstract

Purpose: Apremilast is a phosphodiesterase-4 inhibitor FDA approved for psoriatic arthritis and moderate to severe plaque psoriasis. In recent years, multiple studies have suggested other potential uses for apremilast in dermatology. A summary of these various studies will be a valuable aid to dermatologists considering apremilast for an alternative indication. Materials and Methods: The PubMed/MEDLINE and ClinicalTrials.gov databases were queried with the term ‘apremilast’, with results manually screened to identify published data on off-label uses of apremilast. Results from case reports and case series on a specific disease were omitted if randomized controlled data on that disease was available. The article was structured by the quality of evidence available. Results: Apremilast use in dermatology beyond plaque psoriasis and psoriatic arthritis is well described in the literature, with a mixture of positive and negative results. Randomized controlled data is available for Behçet’s disease, hidradenitis suppurativa, nail/scalp/palmoplantar psoriasis, and atopic dermatitis. Conclusion: The relatively safe adverse effect profile of apremilast and its broad immunomodulatory characteristics may make it a promising option in the future for patients with difficult to treat diseases in dermatology, refractory to first line therapies, but further studies will be necessary to clarify its role.

Publication
In Journal of Dermatological Treatment 9: 1-10
Date