Efficacy and safety of apremilast in patients with moderate to severe chronic plaque psoriasis.

Objective: To measure efficacy and safety of apremilast in patients with moderate to severe chronic plaque psoriasis. Study Design: Non Randomised Clinical Trial. Setting: Department of Dermatology Lahore Medical and Dental College / Ghurki Trust and Teaching Hospital, Lahore and Services Institute of Medical Sciences, Lahore. Period: 6th April 2022 to 31st July 2023. Methods: It was a non-randomized single group clinical trial in which patients were enrolled according to inclusion criteria for 6 months duration. This study was conducted at LMDC/ Ghurki Trust and Teaching Hospital, Lahore and Services Institute of Medical Sciences, Lahore with ethical letter no LM&DC/ 4961-62. Apremilast was given in 30mg twice daily dosage for 16 weeks and follow up was done after a treatment gap of 8 weeks. PASI score and body surface area was calculated before and after treatment. Data was analysed by SPSS version 22.0. Results: 30 patients were enrolled for the trial. Out of them, 12 patients achieved PASI 90, 5 patients achieved PASI 75, 8 patients achieved PASI 50, 7 patients had less than 50% reduction in PASI at the end of 16 weeks. After a treatment gap of 8 weeks 100% patients returned with relapse of psoriasis, with average PASI score of 6.04. Reported side effects included nausea, vomiting, abdominal pain and mild weight loss. Five patients left treatment due to severe nausea, vomiting and abdominal pain. Conclusion: Apremilast significantly reduces signs and symptoms of psoriasis with a good safety profile.