“The main advantage of apremilast is safety – and that’s a big advantage,” Dr. Kavanaugh commented.
Military physicians tell him they are prescribing a lot of apremilast for armed forces deploying overseas because it’s not immunosuppressive and doesn’t entail laboratory testing.
The research agenda for PDE-4 inhibition in psoriatic disease is extensive, he noted. There is a need for formal studies of PDE-4 inhibition in combination with conventional disease-modifying antirheumatic drugs or biologics. Topical formulations, once-daily dosing, and the possibility that PDE-4 inhibition might be the preferred therapy in patients with certain comorbid conditions, such as chronic obstructive pulmonary disease or a history of recurrent infections, are all topics worthy of study. A biomarker to identify in advance which patients with psoriatic arthritis or psoriasis will attain maximum clinical benefit from apremilast, and in which domains, would be of enormous help to clinicians.
Dr. Kavanaugh and Dr. Ruderman reported serving as consultants to and receiving research grants from numerous pharmaceutical companies.