Vitamin D derivatives (calcipotriene) Immunopathogenesis of psoriasis. A wide range of treatments are available for psoriasis, but identifying the most effective one can be difficult. Talk to your doctor if you feel a treatment is not working or you have uncomfortable side effects.
Click here for Sign in to access your subscriptions The biologicals for psoriasis are given by subcutaneous injection, with the exception of infliximab, which is administered intravenously.
Agenda About 7.5 million people in the U.S. Get the facts.
iStockPhoto / Ken Roberts Availability Laser Resurfacing Race Apremilast, an oral PDE4 inhibitor, has been studied in three Phase 3 studies. Two pivotal trials, ESTEEM 1 and ESTEEM 2, have reported significant improvement in scalp psoriasis.47 The studies included patients with moderate-to-very severe scalp psoriasis (ScPGA ≥3) at baseline. The study design included a 16-week placebo-controlled period in which patients were randomized to apremilast 30 mg twice daily or placebo. At 16 weeks, the percentage of patients who achieved an ScPGA score of 0 (clear) or 1 (minimal) was significantly greater in the apremilast group (46.5% versus 17.5% in ESTEEM 1; 40.9% versus 17.2% in ESTEEM 2; P<0.0001 for both).47 During the open-label period, all patients received apremilast 30 mg twice daily from week 16 to week 32. In those patients who received apremilast from baseline, 37.4% and 32.4% of patients achieved an ScPGA score of 0 or 1 (ESTEEM 1 and ESTEEM 2, respectively). Of the patients initially randomized to placebo who switched to apremilast at week 16, 43.6% and 50.7% achieved an improvement in ScPGA score to 0 or 1 at week 32 (ESTEEM 1 and ESTEEM 2, respectively). By the end of week 52, in all patients who were PASI responders, an ScPGA of 0 or 1 was maintained in 83.3% and 62.5% of patients receiving apremilast (ESTEEM 1 and ESTEEM 2, respectively) and in 64.1% and 53.3% of those initially started on placebo and receiving apremilast in the open-label period only (ESTEEM 1 and ESTEEM 2, respectively).47
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