Summary

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• Apremilast (Otezla) is indicated for the treatment of adult patients with active psoriatic arthritis, moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy, and oral ulcers associated with Behçet's disease.
• The information is derived from 24 systematic reviews and meta-analyses.
• In treating moderate-to-severe plaque psoriasis, biologics like infliximab, bimekizumab, ixekizumab, and risankizumab were significantly more effective than apremilast in achieving PASI 90 responses.
• For palmoplantar psoriasis/pustulosis specifically, apremilast showed superior improvement compared to placebo but had comparable efficacy to methotrexate.
• Oral TYK2 inhibitors such as deucravacitinib demonstrated superior efficacy over apremilast in treating plaque psoriasis; however, their safety profiles were similar.
• Long-term studies indicate that newer agents like brodalumab and secukinumab outperform apremilast at achieving significant PASI responses after one year of treatment.
• Real-world evidence supports the safe use of apremilast in patients with serious baseline comorbidities without an increased incidence of severe adverse events.
• Meta-analysis data show significant improvements in mucocutaneous symptoms, including a reduction in oral ulcers for Behçet's disease when treated with apremilast.