Phosphodiesterase 4 Inhibition in the Treatment of Psoriasis, Psoriatic Arthritis and Other Chronic Inflammatory Diseases

• DOI: 10.1007/s13555-013-0023-0
• Publication Date: 2013-05-01T07:51:55Z
• Authors: Miriam Wittmann; Philip S. Helliwell
• Keywords: Apremilast; Roflumilast

Agents which increase intracellular cyclic adenosine monophosphate (cAMP) may have an antagonistic effect on pro-inflammatory molecule production so that inhibitors of the cAMP degrading phosphodiesterases been identified as promising drugs in chronic inflammatory disorders. Although many such developed, their introduction clinic has hampered by narrow therapeutic window with side effects nausea and emesis occurring at sub-therapeutic levels. The latest generation selective for phosphodiesterase 4 (PDE4), apremilast roflumilast, seems to improved index. While roflumilast approved treatment exacerbated obstructive pulmonary disease (COPD), shows activity dermatological rheumatological conditions. Studies psoriasis psoriatic arthritis demonstrated clinical apremilast. Efficacy is probably equivalent methotrexate but less than monoclonal antibody tumour necrosis factor (TNFi). Similarly, efficacy TNF inhibitors. PDE4 hold promise broaden portfolio anti-inflammatory approaches a range diseases include granulomatous skin diseases, some subtypes eczema cutaneous lupus erythematosus. In this review, authors highlight mode action joint responses discuss future role practice. Current developments field including development topical applications specifically target subform PDE4B will be discussed.