Many patients with psoriasis are bothered by symptoms in highly visible, pruritic areas, such as the scalp.
To evaluate the efficacy and safety of apremilast for moderate to severe scalp psoriasis.
This phase 3b, double-blind, placebo-controlled study randomized adults with moderate to severe scalp psoriasis who had inadequate response/intolerance to at least 1 topical scalp psoriasis therapy (NCT03123471). The primary endpoint was the proportion of patients who achieved Scalp Physician Global Assessment response, defined as score of 0 (clear) or 1 (almost clear), with at least a 2-point reduction, at week 16. Secondary endpoints included at least a 4-point improvement from baseline in Whole Body Itch and Scalp Itch Numeric Rating Scales (NRSs) and mean improvement in Dermatology Life Quality Index (DLQI) at week 16.
There were 303 randomized patients (placebo: n = 102; apremilast: n = 201). With apremilast, significantly more patients achieved Scalp Physician Global Assessment (43.3% vs 13.7%), Scalp Itch NRS (47.1% vs 21.1%), and Whole Body Itch NRS (45.5% vs 22.5%) response, and significantly greater DLQI improvement was observed versus placebo (-6.7 vs -3.8; all P < .0001). Common adverse events with apremilast were diarrhea (30.5%), nausea (21.5%), headache (12.0%), and vomiting (5.5%).
Patients with mild disease were not enrolled.
Apremilast showed efficacy for the treatment of moderate to severe scalp psoriasis.Le texte complet de cet article est disponible en PDF.
Key words : apremilast, itching, pruritus, psoriasis, quality of life, scalp
Abbreviations used : AE, BSA, CI, DLQI, ESTEEM, ITT, LIBERATE, LOCF, MI, NRI, NRS, PASI, ScPGA, sPGA, STYLE
| Funding sources: The authors acknowledge financial support for this study from Celgene Corporation. Editorial support was also sponsored by Celgene Corporation. The authors, however, directed and are fully responsible for all content and editorial decisions for this report.
| Disclosure: Dr Van Voorhees has received honoraria for advisory board and/or consulting from AbbVie, Allergan, Celgene Corporation, Derm Tech, Dermira, Novartis, and Valeant. Dr Stein Gold has been an investigator and/or consultant for Celgene Corporation, LEO Pharma, Novartis, Pfizer, and Stiefel/GlaxoSmithKline. Dr Lebwohl is employed by Mount Sinai, which receives funds from Boehringer Ingelheim, Celgene Corporation, Eli Lilly, Janssen/Johnson & Johnson, Kadmon, MedImmune/AstraZeneca, Novartis, Pfizer, and Vidac. Dr Strober has received honoraria as a consultant and advisory board member from AbbVie, Almirall, Amgen, Arena, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene Corporation, Dermavant, Dermira, Eli Lilly, GlaxoSmithKline, Janssen, Kyowa Hakko Kirin, LEO Pharma, Medac, Meiji Seika Pharma, Menlo Therapeutics, Novartis, Ortho Dermatologics/Valeant, Pfizer, Regeneron, Sanofi Genzyme, Sebela Pharmaceuticals, Sun Pharma, and UCB Pharma; has received payments (to the University of Connecticut) as an investigator from AbbVie, Boehringer Ingelheim, Celgene Corporation, Eli Lilly, Galderma, GlaxoSmithKline, Janssen, Merck, Pfizer, and Sienna; has received fees as a scientific director from the Corrona Psoriasis Registry; and has received grant support (to the University of Connecticut for Fellowship Program) from AbbVie and Janssen. Dr Lynde has served as principal investigator/consultant for AbbVie, Boehringer Ingelheim, Celgene Corporation, Eli Lilly, Janssen, Merck, Novartis, Pfizer, Sun Pharma, and Valeant. Dr Cauthen has served as an investigator for AbbVie, Amgen, AstraZeneca, Boehringer Ingelheim, Celgene Corporation, Dermira, Eli Lilly, Janssen, Maruho, Novartis, Pfizer, Stiefel/GlaxoSmithKline, Sun Pharma, and UCB and as a consultant for Celgene Corporation. Dr Sofen has received grants received as an investigator from Celgene Corporation, Janssen, Lilly, and Novartis. Drs Zhang, Paris, and Wang were employees of Celgene Corporation at the time of study conduct. Dr Tyring has no conflicts of interest to declare.
| IRB approval status: Reviewed and approved by the Schulman IRB.