Apremilast: Real-life efficacy and safety in psoriasis limited to the nails.

Overview

BACKGROUND: Apremilast, an oral phosphodiesterase inhibitor, offers advantages in psoriasis patients in whom biologics are not approved or accepted and where topical treatments have failed. Psoriasis involving the nails, scalp, and genitals is difficult to treat and is associated with a significant decrease in quality of life, requiring an effective treatment. OBJECTIVES: This study aimed to retrospectively assess the efficacy and safety of apremilast 30 mg twice daily in treating psoriasis limited to the nails. METHODS: The charts of 55 adult patients with nail psoriasis treated with apremilast were retrospectively evaluated. Baseline characteristics, including the nail psoriasis severity index (NAPSI) and dermatology life quality index (DLQI), were recorded. RESULTS: At 6 months of treatment, a statistically significant decrease in both the NAPSI score (44.7 ± 26.9 vs. 19.03 ± 14.2) and the DLQI score (14.5 ± 5 vs. 7.2 ± 4.1) was observed (p < 0.01). None of the patients discontinued the treatment due to side effects. CONCLUSIONS: This study shows improvements in nail psoriasis severity and quality of life with apremilast treatment. Despite potential confounders like psoriatic arthritis, smoking, and manual work, consistent improvements were observed. Apremilast appears to be a valuable treatment option for nail psoriasis. However, further prospective studies are necessary to address the limitations of this retrospective analysis and explore additional endpoints.