Scalp psoriasis is common; however, oral systemic treatments for it are not. Otezla® is poised to change that. On April 10, 2020, the U.S. Food and Drug Administration approved the use of Otezla® (apremilast) for use in patients with moderate to severe plaque psoriasis of the scalp.
“Of the people who have psoriasis, easily 50 percent to 60 percent have scalp psoriasis either alone or in conjunction with other psoriasis plaques, meaning millions of people are affected. In fact, scalp psoriasis is one of the more common areas for psoriasis, along with elbows and knees. The severity of scalp psoriasis can vary from flaky, itchy, scaly and slightly red to a situation where the whole scalp is covered with raised, scaly plaques,” said Jerry Bagel, M.D., director of the Psoriasis Treatment Center of Central New Jersey, dermatology instructor at Columbia University College of Physicians and Surgeons in New York and Drexel University College of Medicine in Philadelphia and a member of the NPF board of directors.
Otezla®, manufactured by Amgen, is proposed to work by inhibiting phosphodiesterase 4 (PDE4), an enzyme that helps to regulate inflammation in the body. It is thought that when there is a low concentration of cyclic adenosine monophosphate (cAMP) levels in the cell, then inflammatory signaling is increased. Otezla® inhibits PDE4 which increases cAMP concentration in the cell, dampening inflammatory signaling. By elevating cAMP levels, Otezla® is thought to indirectly modulate production of pro-inflammatory and anti-inflammatory mediators.
“Having a new treatment option for scalp psoriasis is remarkable. Many people try multiple therapies, many of which don’t work. The topical treatments have to get through hair to the scalp plaques, but patients find it very challenging to wash the treatments out of their hair. Some patients even experience hair loss,” said Dr. Bagel.
“Patients are always looking for something safe, effective and easy to use. And health care providers often run out of options for our patients, particularly when the scalp is the main area of concern, and we welcome new options,” added Laura Korb Ferris, M.D., Ph.D., a dermatologist and Associate Professor at the University of Pittsburgh Clinical and Translational Science Institute and Director of Clinical Trials, UPMC Department of Dermatology.
Otezla® was previously approved for the treatment of adults with psoriatic arthritis, adults with moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy, and adults with oral ulcers associated with Behcet’s Disease.
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