{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T01:06:35Z","timestamp":1788397595644,"version":"build-2803163510"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"Abstract:<\/jats:title>\n \n OBJECTIVES:<\/jats:title>\n \n Apremilast, proven to be effective against psoriasis, has many side effects at the standard dose of 30 mg, impacting adherence. Hence, we aimed to compare the lower doses (10 mg and 20 mg) to the 30 mg apremilast dose. Primary objectives were to compare psoriasis area and severity index (PASI) 75 response and adverse events (AEs) in apremilast 30 mg versus 20 mg, and 30 mg versus 10 mg from baseline to 16\n th<\/jats:sup>\n week.\n <\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n \n In this randomized, active-controlled trial, 124 patients with mild to moderate psoriasis were randomized (1:1:1 ratio) to apremilast 10 mg, 20 mg, or 30 mg twice daily for 16 weeks. Efficacy parameters were evaluated at 16\n th<\/jats:sup>\n week, and safety was monitored every 2 weeks.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n At week 16, PASI 75 response was comparable between apremilast 30 mg (31.7%) and 20 mg (28.6%) (\n P<\/jats:italic>\n = 0.756), but significantly higher than 10 mg (9.8%) (\n P<\/jats:italic>\n = 0.014). Apremilast 30 mg and 20 mg demonstrated comparable static physician global assessment 0\/1 responses (39% vs. 31%,\n P<\/jats:italic>\n = 0.441), whereas 30 mg significantly outperformed 10 mg (12.2%,\n P<\/jats:italic>\n = 0.005). Common AEs observed in all groups were nausea and headache. Apremilast 30 mg exhibited significantly more AEs than 20 mg (\n P<\/jats:italic>\n = 0.023) and 10 mg (\n P<\/jats:italic>\n = 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION:<\/jats:title>\n Apremilast 20 mg demonstrated comparable efficacy with significantly fewer side effects than the 30 mg dose in mild-to-moderate psoriasis, while apremilast 10 mg showed no significant improvement in efficacy compared to the 30 mg dose.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijp.ijp_896_25","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T18:00:15Z","timestamp":1782410415000},"page":"342-349","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and safety of different doses of apremilast in mild to-moderate psoriasis: A randomized controlled study"],"prefix":"10.4103","volume":"58","author":[{"given":"Abhishek","family":"Anil","sequence":"first","affiliation":[{"name":"Department of Pharmacology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aswini","family":"Saravanan","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Budania","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isha","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradeep","family":"Dwivedi","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoban Babu","family":"Varthya","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sneha","family":"Ambwani","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surjit","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"R2-20260626","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1007\/s13555-021-00518-8","article-title":"Psoriasis prevalence and severity by expert elicitation","volume":"11","author":"Papp","year":"2021","journal-title":"Dermatol Ther (Heidelb)"},{"key":"R3-20260626","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1001\/jamadermatol.2021.2007","article-title":"Psoriasis prevalence in adults in the United States","volume":"157","author":"Armstrong","year":"2021","journal-title":"JAMA Dermatol"},{"key":"R4-20260626","first-page":"626","article-title":"Psoriasis","volume":"87","author":"Weigle","year":"2013","journal-title":"Am Fam Physician"},{"key":"R6-20260626","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1136\/annrheumdis-2013-205056","article-title":"Treatment of psoriatic arthritis in a phase 3 randomised, placebo-controlled trial with apremilast, an oral phosphodiesterase 4 inhibitor","volume":"73","author":"Kavanaugh","year":"2014","journal-title":"Ann Rheum Dis"},{"key":"R7-20260626","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1136\/annrheumdis-2015-207963","article-title":"Apremilast, an oral phosphodiesterase 4 inhibitor, in patients with psoriatic arthritis and current skin involvement: A phase III, randomised, controlled trial (PALACE 3)","volume":"75","author":"Edwards","year":"2016","journal-title":"Ann Rheum Dis"},{"key":"R8-20260626","first-page":"801","article-title":"Efficacy and safety of apremilast in patients with moderate plaque psoriasis with lower BSA: Week 16 results from the UNVEIL study","volume":"16","author":"Strober","year":"2017","journal-title":"J Drugs Dermatol"},{"key":"R9-20260626","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta15suppl1-01","article-title":"Etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis: A systematic review and economic evaluation","volume":"15","author":"Rodgers","year":"2011","journal-title":"Health Technol Assess"},{"key":"R10-20260626","doi-asserted-by":"crossref","first-page":"278","DOI":"10.4103\/ijd.ijd_420_23","article-title":"Disease assessment in psoriasis","volume":"68","author":"Manchanda","year":"2023","journal-title":"Indian J Dermatol"},{"key":"R11-20260626","doi-asserted-by":"crossref","first-page":"497","DOI":"10.2340\/00015555-1265","article-title":"Visual analogue scale: Evaluation of the instrument for the assessment of pruritus","volume":"92","author":"Reich","year":"2012","journal-title":"Acta Derm Venereol"},{"key":"R13-20260626","doi-asserted-by":"crossref","first-page":"581","DOI":"10.4103\/ijem.IJEM_46_17","article-title":"Randomized placebo control study of metformin in psoriasis patients with metabolic syndrome (systemic treatment cohort)","volume":"21","author":"Singh","year":"2017","journal-title":"Indian J Endocrinol Metab"},{"issue":"Suppl 11","key":"R14-20260626","first-page":"S64","article-title":"Measures of psoriatic arthritis: Tender and swollen joint assessment, psoriasis area and severity index (PASI), nail psoriasis severity index (NAPSI), modified nail psoriasis severity index (mNAPSI), Mander\/newcastle enthesitis index (MEI), leeds enthesitis index (LEI), spondyloarthritis research consortium of Canada (SPARCC), Maastricht ankylosing spondylitis enthesis score (MASES), Leeds dactylitis index (LDI), Patient Global for psoriatic arthritis, dermatology life quality index (DLQI), Psoriatic arthritis quality of life (PsAQOL), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Psoriatic arthritis response criteria (PsARC), Psoriatic Arthritis Joint Activity Index (PsAJAI), disease activity in psoriatic arthritis (DAPSA), and composite psoriatic disease activity index (CPDAI)","volume":"63","author":"Mease","year":"2011","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"R16-20260626","doi-asserted-by":"crossref","first-page":"1021537","DOI":"10.3389\/fimmu.2022.1021537","article-title":"Efficacy and safety profile of phosphodiesterase 4 inhibitor in the treatment of psoriasis: A systematic review and meta-analysis of randomized controlled trials","volume":"13","author":"Kang","year":"2022","journal-title":"Front Immunol"},{"key":"R17-20260626","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1111\/jdv.14015","article-title":"The efficacy and safety of apremilast, etanercept and placebo in patients with moderate-to-severe plaque psoriasis: 52-week results from a phase IIIb, randomized, placebo-controlled trial (LIBERATE)","volume":"31","author":"Reich","year":"2017","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"R18-20260626","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1111\/bjd.14164","article-title":"Efficacy and safety of apremilast, an oral phosphodiesterase 4 inhibitor, in patients with moderate-to-severe plaque psoriasis over 52 weeks: A phase III, randomized controlled trial (ESTEEM 2)","volume":"173","author":"Paul","year":"2015","journal-title":"Br J Dermatol"},{"key":"R19-20260626","doi-asserted-by":"crossref","first-page":"e376","DOI":"10.1111\/j.1468-3083.2012.04716.x","article-title":"Efficacy and safety of apremilast in subjects with moderate to severe plaque psoriasis: Results from a phase II, multicenter, randomized, double-blind, placebo-controlled, parallel-group, dose-comparison study","volume":"27","author":"Papp","year":"2013","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"R20-20260626","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1093\/rheumatology\/keab449","article-title":"Apremilast monotherapy for long-term treatment of active psoriatic arthritis in DMARD-na\u00efve patients","volume":"61","author":"Wells","year":"2022","journal-title":"Rheumatology (Oxford)"},{"key":"R21-20260626","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1002\/acr2.11156","article-title":"Long-term safety and tolerability of apremilast versus placebo in psoriatic arthritis: A pooled safety analysis of three phase III, randomized, controlled trials","volume":"2","author":"Mease","year":"2020","journal-title":"ACR Open Rheumatol"},{"key":"R22-20260626","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1177\/1203475417748886","article-title":"Management of common side effects of apremilast","volume":"22","author":"Langley","year":"2018","journal-title":"J Cutan Med Surg"},{"key":"R23-20260626","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s40257-017-0302-0","article-title":"Apremilast: A novel oral treatment for psoriasis and psoriatic arthritis","volume":"19","author":"Torres","year":"2018","journal-title":"Am J Clin Dermatol"},{"key":"R24-20260626","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.jaad.2023.10.020","article-title":"Efficacy and safety of apremilast in patients with moderate-to-severe genital psoriasis: Results from DISCREET, a phase 3 randomized, double-blind, placebo-controlled trial","volume":"90","author":"Merola","year":"2024","journal-title":"J Am Acad Dermatol"},{"key":"R25-20260626","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1007\/s13555-022-00747-5","article-title":"Efficacy and safety of apremilast in the treatment of patients with mild-to-moderate psoriasis in Japan: Results from PROMINENT, A phase 3b, open-label, single-arm study","volume":"12","author":"Okubo","year":"2022","journal-title":"Dermatol Ther (Heidelb)"},{"key":"R26-20260626","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.jaad.2015.03.049","article-title":"Apremilast, an oral phosphodiesterase 4 (PDE4) inhibitor, in patients with moderate to severe plaque psoriasis: Results of a phase III, randomized, controlled trial (efficacy and safety trial evaluating the effects of apremilast in psoriasis [ESTEEM] 1)","volume":"73","author":"Papp","year":"2015","journal-title":"J Am Acad Dermatol"},{"key":"R27-20260626","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1093\/rheumatology\/keab474","article-title":"Effect of the phosphodiesterase 4 inhibitor apremilast on cardiometabolic outcomes in psoriatic disease-results of the immune metabolic associations in psoriatic arthritis study","volume":"61","author":"Ferguson","year":"2022","journal-title":"Rheumatology (Oxford)"}],"container-title":["Indian Journal of Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijp.ijp_896_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T12:24:52Z","timestamp":1787747092000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijp.ijp_896_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ijp.ijp_896_25","relation":{},"ISSN":["0253-7613","1998-3751"],"issn-type":[{"value":"0253-7613","type":"print"},{"value":"1998-3751","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2025-08-27","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-30","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}