New Oral Treatments

Oral treatments are small molecule medicines that are taken by mouth. Unlike earlier pills used for psoriasis and psoriatic arthritis, the latest oral treatments selectively target molecules inside immune cells. By adjusting the complicated processes of inflammation within the cell, these treatments correct the overactive immune response that causes inflammation in those with psoriatic disease. leading to improvement in redness and a reduction in psoriasis scales, tenderness and swelling.

Otezla (apremilast)

Otezla treats psoriasis and psoriatic arthritis by regulating inflammation within the cell. It inhibits an enzyme known as phosphodiesterase 4 (PDE4). This enzyme controls much of the inflammatory action within cells, which can affect the level of inflammation associated with psoriatic disease.

How is it used?

Otezla is available as a 30-milligram (mg) tablet. The first five days is a start period, where the dosage will gradually increase until the recommended dose of 30 milligrams (twice daily) is reached. Otezla is meant to be taken continuously to maintain improvement.

What are the risks?

There have been rare reports of:

  • Gastrointestinal problems, including diarrhea, nausea and vomiting
  • Depression
  • Weight decrease

Common side effects

In clinical trials, the most common side effects were diarrhea, nausea, headache and upper respiratory infection.

Using Otezla with other treatments

Otezla can be used with other treatments such as phototherapy or topicals. It has been shown to be safe and effective when taken with methotrexate. Talk to your health care provider about whether using any other treatments with Otezla is right for you.

Download the Otezla fact sheet (pdf) »


Xeljanz and Xeljanz XR (tofacitinib)

Aimed at reducing psoriatic arthritis inflammation, Xeljanz targets a specific part of the immune system (Janus kinase) to reduce the overactive response associated with psoriatic disease. The oral treatment also aids in reducing joint tenderness and swelling.

How is it used?

Xeljanz is taken by mouth twice daily as a pill. Xeljanz XR is an extended release formula of the same treatment and is taken by mouth once daily as a pill.

What are the risks?

Xeljanz/Xeljanz XR may raise your risk for:

  • High lipid levels
  • High liver enzymes
  • Low blood count
  • Lymphoma and other malignancies
  • Gastrointestinal (GI) perforations

Common side effects

In clinical trials, the most common side effects were headaches, diarrhea and upper respiratory infections.

Help is here for you

NPF’s Patient Navigation Center is the world's first, personalized support center for psoriatic disease. Our patient navigators can answer your questions about new oral treatments, including understanding their side effects and helping assess potential risks. For free and confidential assistance, contact our patient navigators »

Get the facts on new oral treatments

NPF’s systemic treatment booklet will help you navigate treatments and provide you with a comprehensive breakdown on some of the more popular medications on the market today.

Test your treatment IQ

How much do you know about your psoriatic disease treatment options? Put your knowledge to the test with our treatment quiz and let NPF help you fill in some of the gaps.


Last updated  by the National Psoriasis Foundation