Apremilast for the treatment of moderate-to-severe
palmoplantar psoriasis: results from a double-blind,
placebo-controlled, randomized study
* R. Haydey,
Innovaderm Research, Montreal, QC, Canada
Winnipeg Clinic, Winnipeg, MB, Canada
North Bay Dermatology Centre, North Bay, ON, Canada
Lynderm Research, Markham, ON, Canada
Altman Dermatology Associates, Arlington Heights, IL, USA
Dermatology Specialists Research, Louisville, KY, USA
Dr Isabelle Delorme Inc., Drummondville, QC, Canada
e-Henley MD Inc., Saint-J
ome, QC, Canada
Dr. Melinda Gooderham SKiN Centre for Dermatology, Peterborough, ON, Canada
Centre de Recherche Dermatologique du Qu
ebec, QC, Canada
Kirk Barber Research, Calgary, AB, Canada
Dermatology Associates, Seattle, WA, USA
Nexus Clinical Research, St. John’s, NL, Canada
Department of Dermatology, Eastern Virginia Medical School and Virginia Clinical Research Inc., Norfolk, VA, USA
*Correspondence: R. Bissonnette. E-mail: firstname.lastname@example.org
Background Palmoplantar psoriasis is a variant of psoriasis vulgaris which can severely impair quality of life.
Objectives The main objectives of this double-blind, placebo-controlled, randomized study were to assess the efﬁcacy
and impact on quality of life and work productivity of apremilast for the treatment of moderate-to-severe palmoplantar
Methods A total of 100 patients with moderate-to-severe palmoplantar psoriasis were randomized to either apremilast
30 mg bid or placebo for 16 weeks. At Week 16, all patients received apremilast 30 mg bid until Week 32. The primary
endpoint was the proportion of patients who achieved a Palmoplantar Psoriasis Physician Global Assessment (PPPGA)
of 0/1 at Week 16.
Results There was no signiﬁcant difference in the proportion of patients who achieved a PPPGA of 0/1 at Week 16
between patients randomized to apremilast (14%) and placebo (4%; P = 0.1595). After 32 weeks of treatment with
apremilast, 24% of patients achieved a PPGA of 0/1. In addition, apremilast was superior to placebo in achieving Palmo-
plantar Psoriasis Area Severity Index (PPPASI) 75 (apremilast: 22%; placebo: 8%; P = 0.0499), in improving PPPASI
(apremilast: À7.4 Æ 7.1; placebo: À3.6 Æ 5.9; P = 0.0167), Dermatology Life Quality Index score (apremilast:
À4.3 Æ 5.1; placebo: À0.8 Æ 4.5; P = 0.0004) and in reducing activity impairment (apremilast: À11.0 Æ 22.3; placebo:
2.5 Æ 25.5; P = 0.0063).
Conclusion Despite the absence of a signiﬁcant difference between apremilast and placebo in proportion of patients
achieving a PPPGA of 0/1, the presence of signiﬁcant differences observed for several secondary endpoints suggests
that apremilast may have a role in the treatment of moderate-to-severe palmoplantar psoriasis.
Received: 25 August 2017; Accepted: 6 October 2017
Conﬂicts of interest
Dr. Robert Bissonnette has received grants, and research support, served as a consultant or received honoraria
from Abbvie, Amgen, Apopharma, Boehringer Ingelheim, Celgene, Dermira, Eli Lilly, Galderma, GSK-Stiefel,
Incyte, Janssen, Kineta, Leo Pharma, Merck, Novartis, Pﬁzer, Regeneron, Tribute and Xenoport. He is a
shareholder of Innovaderm Research.
Dr. Richard Haydey has received grants, and research support, served as a consultant or received honoraria from
Abbvie, Amgen, Celgene, Janssen, Eli Lilly, Novartis and Leo Pharma.
© 2017 European Academy of Dermatology and Venereology
2018, 32, 403–410