OBJECTIVE: To review the pharmacology, efficacy, and safety of apremilast and 
determine its role relative to other agents in the treatment of psoriasis and 
psoriatic arthritis.
DATA SOURCES: A PubMed search (1946 to December 2015) using the terms apremilast 
and CC-10004 was conducted to identify relevant articles.
STUDY SELECTION AND DATA EXTRACTION: In vitro or in vivo evaluations of 
apremilast published in the English language were eligible for inclusion. 
Controlled clinical trials that involved psoriasis or psoriatic arthritis were 
selected for review.
DATA SYNTHESIS: Four trials were identified on the treatment of psoriasis. In 
those that involved doses of 30 mg twice daily, a significantly greater 
percentage of patients receiving apremilast (28.8% to 40.9%) compared with 
placebo (5.3% to 5.8%) achieved at least 75% improvement from baseline in 
Psoriasis Area and Severity Index score at 16 weeks. Two trials were identified 
on the treatment of psoriatic arthritis. In the one that involved a dose of 30 
mg twice daily, a significantly greater percentage of patients receiving 
apremilast (38.1%) compared with placebo (19.0%) achieved the American College 
of Rheumatology criteria for 20% improvement at 16 weeks. In all trials, the 
drug had an acceptable safety profile, with the most common adverse effects of 
diarrhea, nausea, and headache.
CONCLUSIONS: Apremilast has a novel mechanism of action and is safe and 
effective for the management of psoriasis and psoriatic arthritis. At this time, 
apremilast should be reserved for patients unable to take disease-modifying 
antirheumatic drugs.