Skip to main content

Apremilast Equals MTX in Palmoplantar Psoriasis

Mar 18, 2021 12:54 pm

Palmoplantar psoriasis (PPP) is a therapeutically challenging variant of psoriasis; nonetheless, a prospective, randomized, active-controlled trial from India suggests that apremilast is effective and safe in patients with PPP.

A total of 84 patients from tertiary psoriasis clinic with active palmoplantar psoriasis were randomized to receive either methotrexate (0.4 mg/kg/week orally) or apremilast (30 mg twice daily). The primary endpoints was the 16 week m-PPASI75 (≥ 75% improvement in the Modified Palmoplantar Psoriasis Area and Severity Index) and Dermatology Life Quality Index scores were assessed..

The change in m-PPPASI score at 16 weeks was significant for both groups (median change):

  • Apremilast [- 6.3 (10.9), p < 0.001]
  • Methotrexate groups [- 8.5 (9.9), p < 0.001]

The percentage of patients achieving a m-PPPASI 75 at 16 weeks was also equivalent (but again favored MTX):

  • Apremilast responders 14/42 (33%)
  • MTX responders  17/42 (41%) (comparison p = 0.49)

Both groups had a significant reduction in the Dermatology Life Quality Index score:

  • Apremilast: - 3.0 (6.0)
  • MTX  - 3.0 (6.3)

The adverse events were comparable between groups (p = 0.49).

Apremilast showed a comparable efficacy and safety profile to methotrexate in patients with palmoplantar psoriasis.

The author has no conflicts of interest to disclose related to this subject

Add new comment

If you are a health practitioner, you may to comment.

Due to the nature of these comment forums, only health practitioners are allowed to comment at this time.