Open AccessPhosphodiesterase-4 Inhibition in Psoriasis
Author(s) -
Milica Milakovic,
Melinda Gooderham
Publication year - 2021
Publication title -
psoriasis
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 1.066
H-Index - 4
ISSN - 2230-326X
DOI - 10.2147/ptt.s303634
Subject(s) - apremilast , psoriasis , roflumilast , medicine , phosphodiesterase , pharmacology , phosphodiesterase inhibitor , adenosine monophosphate , adverse effect , cyclic adenosine monophosphate , adenosine , atopic dermatitis , dermatology , enzyme , chemistry , psoriatic arthritis , biochemistry , copd , receptor
Psoriasis is a chronic immune-mediated inflammatory disorder. Phosphodiesterase-4 (PDE-4) is an enzyme that mediates inflammatory responses and plays a role in psoriasis pathogenesis. PDE-4 degrades its substrate cyclic adenosine monophosphate (cAMP) to adenosine monophosphate (AMP), which subsequently leads to the production of pro-inflammatory mediators. Inhibitors of PDE-4 work by blocking the degradation of cAMP, which leads to a reduction in inflammation. Apremilast is the only approved oral PDE-4 inhibitor for the treatment of psoriasis. While it is effective for some patients, it may be limited by adverse effects in others. A topical PDE-4 inhibitor, roflumilast, is being investigated in psoriasis and showing promising results. Crisaborole, a topical PDE-4 inhibitor approved for use in atopic dermatitis, has also been investigated in psoriasis. This is an updated comprehensive review to summarize the currently available evidence for the PDE-4 inhibitors apremilast, roflumilast and crisaborole in the treatment of psoriasis, with a focus on data from randomized clinical trials.