AT A GLANCE

A Japanese claims study finds apremilast decreases prescribed topical steroid and vitamin D analogue use in psoriasis, with some patients discontinuing topicals altogether.

Topical corticosteroids and vitamin D analogues remain mainstays of psoriasis management, yet long-term reliance carries risks and treatment burden. To assess whether systemic therapy with apremilast can reduce topical medication use, a retrospective cohort study analyzed health insurance claims data from Japan’s JMDC database. The study included 319 adults with psoriasis who initiated apremilast between March 2018 and July 2021 and had received topical therapies within the preceding six months.

Comparing prescription data six months before and after apremilast initiation, researchers observed significant decreases in cumulative steroid use (195.8 ± 236.1 g to 162.2 ± 230.9 g; p<0.001) and vitamin D analogues (84.6 ± 89.6 g to 77.1 ± 104.6 g; p=0.018). The reduction in steroids was limited to “very strong” potency formulations, while no significant changes were observed for fixed-dose combinations or overall topical therapy volume. Additionally, 6% of patients discontinued topical therapy altogether, and 22% reduced the number of concomitant topical prescriptions.

These real-world findings suggest that apremilast may reduce dependency on certain topical therapies in psoriasis, potentially lowering cumulative steroid exposure while simplifying treatment regimens.

Reference: Chaudhari S, Ogawa R, Imafuku S, Saruwatari H, Jabłońska K, Tran K. Initiation of apremilast treatment decreases prescribed topical therapy amount in patients with psoriasis: a health insurance claims study in Japan. J Dermatolog Treat. 2025 Dec;36(1):2535686. doi: 10.1080/09546634.2025.2535686. Epub 2025 Jul 28. PMID: 40719230.

DRUG AT A GLANCE

Apremilast (Otezla) is an oral phosphodiesterase 4 (PDE4) inhibitor that is U.S. Food and Drug Administration approved for the treatment of moderate-to-severe plaque psoriasis, psoriatic arthritis, and oral ulcers associated with Behçet’s disease.