Efficacy of apremilast for psoriasis: a meta-analysis of randomized controlled studies

INTRODUCTION: The efficacy of apremilast for psoriasis remains controversial. AIM: We have conducted a systematic review and meta-analysis to explore the influence of apremilast on treatment efficacy for psoriasis. MATERIAL AND METHODS: We have searched PubMed, Embase, Web of science, EBSCO, and Cochrane library databases for randomized controlled trials (RCTs) published until February 2022 and assessing the efficacy and safety of apremilast for psoriasis. This meta-analysis was performed using the random-effects model. RESULTS: Seven RCTs were included in the meta-analysis. Overall, compared with placebo for psoriasis, apremilast was associated with improved PASI-75 (LOCF) (OR = 6.59; 95% CI: 4.55 to 9.53; p < 0.00001), PASI-75 (NRI) (OR = 6.99; 95% CI: 4.43 to 11.04; p < 0.00001), sPGA response (LOCF) (OR = 5.58; 95% CI: 3.82 to 8.16; p < 0.00001), sPGA response (NRI) (OR = 6.06; 95% CI: 4.07 to 9.02; p < 0.00001), PASI-50 (LOCF) (OR = 4.37; 95% CI: 2.72 to 7.01; p < 0.00001), PASI-90 (LOCF) (OR = 7.81; 95% CI: 2.89 to 21.08; p < 0.0001), adverse events (OR = 1.58; 95% CI: 1.19 to 2.10; p = 0.002), but demonstrated no increase in serious adverse events (OR = 1.01; 95% CI: 0.43 to 2.33; p = 0.99). CONCLUSIONS: Apremilast is effective and safe to treat psoriasis.