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- DOI 10.18231/j.ijced.2025.038
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CrossMark
Comparative evaluation of therapeutic efficacy and safety of apremilast versus cyclosporine in psoriasis vulgaris
- Author Details:
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Anjugam Alagappan *
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Balaguru Natarajan
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Balvinder Kaur Brar
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Sumir Kumar
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Amarbir Singh Boparai
Anjugam Alagappan *
Balaguru Natarajan
Background: Psoriasis is a chronic relapsing inflammatory skin condition with various treatment options, but achieving significant lesion clearance with minimal side effects remains challenging.
Aims: To compare efficacy and safety of Apremilast and Cyclosporine in the treatment of chronic plaque psoriasis.
Materials and Methods: This study was conducted with two groups of thirty participants each. Group A received Cyclosporine (2.5 to 5 mg/kg/day), while Group B received Apremilast (daily 60mg in two divded doses) for 16 weeks and evaluated at baseline and at 4, 8, 12, 16, and 24 weeks using the Psoriasis Area and Severity Index (PASI), Body Surface Area (BSA) and serial photographic assessments.
Results: The clinico-demographic parameters were comparable between the two groups. The mean PASI score in the Cyclosporine group decreased from 10.90±5.5 to 3.10±1.8 (P 0.001) at the end of 16 weeks, while in the Apremilast group, it decreased from 11.27±5.5 to 3.47±2. 1(P 0.04). The mean baseline BSA in Group A was 40.00±18.274, which decreased to 9.30±5.694 at 16 weeks (P 0.001) while in Group B, it decreased from 39.80±16.238 to 15.70±9.248 (P 0.001). Both treatments demonstrated similar efficacy in reducing the scores (P 0.669).
Conclusion: Apremilast demonstrated similar efficacy to Cyclosporine with the added benefits of lower cost and less need for laboratory monitoring. However, apremilast was linked to significant gastrointestinal side effects. Thus, this study shows that Apremilast is a valuable addition to the treatment armamentarium of psoriasis and may even be a suitable first-line treatment, particularly for patients with contraindications to other traditional systemic therapies or for use in combination or rotational therapy.
Keywords: Chronic plaque psoriasis, Apremilast, PDE-4 inhibitor, Cyclosporine