BACKGROUND: Apremilast, an oral phosphodiesterase 4 inhibitor, has an acceptable 
safety profile and is effective for treatment of plaque psoriasis and psoriatic 
arthritis.
OBJECTIVES: To evaluate the impact of apremilast on health-related quality of 
life (HRQOL), general functioning and mental health using patient-reported 
outcome (PRO) assessments among patients with moderate to severe plaque 
psoriasis in the ESTEEM 1 and 2 trials.
METHODS: A total of 1255 patients were randomized (2 : 1) to apremilast 30 mg 
BID or placebo for 16 weeks; all received apremilast through Week 32. PRO 
assessments included the Dermatology Life Quality Index (DLQI), 36-Item 
Short-Form Health Survey version 2 mental/physical component summary scores 
(SF-36v2 MCS/PCS), Patient Health Questionnaire-8 (PHQ-8), EuroQol-5D (EQ-5D) 
and Work Limitations Questionnaire-25 (WLQ-25). Post hoc analyses examined 
relationships between Psoriasis Area and Severity Index (PASI) scores and PHQ-8 
in the apremilast-treated population at Week 16.
RESULTS: Treatment with apremilast improved all HRQOL PROs at Week 16 (vs. 
placebo), except the SF-36v2 PCS, and improvements were sustained through Week 
32. Mean DLQI and SF-36v2 MCS improvements exceeded minimal clinically important 
differences. Changes at Week 16 in PHQ-8 and PASI were weakly correlated, and 
only 35.8% of patients who achieved a ≥75% reduction from baseline in PASI score 
(PASI-75) with apremilast treatment also achieved PHQ-8 scores of 0-4.
CONCLUSIONS: Apremilast led to improvements in HRQOL PROs vs. placebo in 
patients with moderate to severe plaque psoriasis.