BACKGROUND: Increased knowledge of the molecular regulatory mechanisms that 
contribute to the pathogenesis of psoriasis and other inflammatory diseases has 
created new opportunities for the development of targeted drug therapy for 
inflammatory conditions. Two new oral medications, apremilast and tofacitinib, 
have been developed for their immunomodulatory properties, and their potential 
efficacy in treating psoriasis is being evaluated.
METHODS: We reviewed phase III randomized, placebo-controlled clinical trial 
results for apremilast and tofacitinib for efficacy and safety in psoriasis.
RESULTS: Psoriasis Area and Severity Index (PASI) 75 after 16 weeks for 
apremilast was between 28.8% and 33.1%. PASI 75 was 39.5% after 12 weeks on 
tofacitinib 5 mg, and 63.6% after 12 weeks on tofacitinib 10 mg. Common side 
effects for both drugs included nasopharyngitis and upper respiratory tract 
infections. Gastrointestinal disturbance was common for apremilast. Dyslipidemia 
and infections were more common with tofacitinib than placebo.
CONCLUSION: Both new oral medications, apremilast and tofacitinib, appear to be 
effective in treating psoriasis