What Everyone with Psoriasis Needs to Know About PDE4 Inhibitors

What everyone needs to know about PDE4 inhibitors: Overview

Psoriatic Arthritis (PRA) is a chronic inflammatory skin disease characterized by the presence of plaques on the epidermis, dermis, or both. These lesions cause pain and tenderness when touched, causing significant disability.

People with psoriasis have increased risk of developing PRA.1

The most common type of psoriasis is called nodular psoriasis.2 Nodular means “naked” because these plaques are usually not inflamed, but rather dry and smooth.3 They may appear on any part of the body, including the scalp, palms of hands, soles of feet, elbows and knees.4 The plaque forms over time and becomes larger as it ages.5

Other types of psoriasis include mixed plaque/triggers, which includes psoriasis caused by environmental factors such as sun exposure, cigarette smoke, alcohol use, and certain medications.6 Other types of psoriasis include non-inflammatory psoriasis (also known as ichthyosis), which does not involve plaques.7 Non-inflammatory psoriasis is often associated with a genetic predisposition to develop it.8

What are PDE4 Inhibitors?

A new type of drug called a phosphodiesterase-4 (PDE-4) inhibitor was recently approved by the FDA for use in people with psoriasis. Two PDE-4 inhibitors are currently available:

Tofacitinib (Xeljanz) is used for the treatment of adult patients with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.

Ruxolitinib (Jakafi) is used for the treatment of adult patients with severe systemic rheumatoid arthritis in conjunction with methotrexate (MTX), who have had an inadequate response to one or more tumor necrosis factor (TNF) blockers.

PDE-4 Inhibitors can be used alone or in combination with other medications (or phototherapy) to treat people with psoriasis.9

How to reduce the risk of skin cancer in people with PRA

The skin is highly susceptible to sun damage, and people with psoriasis have a 50 percent increased risk of developing skin cancer. Sunburns during childhood or adolescence can increase your risk even more.

To help prevent skin cancer, avoid excessive sun exposure and get regular check-ups by a board-certified dermatologist.10

What should I look for when choosing a PDE-4 inhibitor?

Sources & references used in this article:

Genomics and personalized medicine: what everyone needs to know by M Snyder – 2016 – books.google.com

Group for research and assessment of psoriasis and psoriatic arthritis 2015 treatment recommendations for psoriatic arthritis by LC Coates, A Kavanaugh, PJ Mease… – Arthritis & …, 2016 – Wiley Online Library

Treatment of irritant and allergic contact dermatitis by DE Cohen, N Heidary – Dermatologic Therapy, 2004 – Wiley Online Library

IL-12/IL-23p40 identified as a downstream target of apremilast in ex vivo models of arthritis by TW Kragstrup, M Adams, S Lomholt… – Therapeutic …, 2019 – journals.sagepub.com