Drakos Anastasia, Vender Ron, Torres Tiago
Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Dermatrials Research Inc. & Venderm Innovations in Psoriasis, Hamilton, ON, Canada.
Expert Rev Clin Immunol. 2023 Jul-Dec;19(9):1053-1062. doi: 10.1080/1744666X.2023.2219897. Epub 2023 May 30.
New non-steroidal topical agents are needed for the treatment of psoriasis. Roflumilast cream 0.3% is a once daily phosphodiesterase-4 inhibitor that was recently approved by the FDA for the treatment of plaque psoriasis in adolescents and adults. It is indicated for use on all body surfaces including intertriginous areas.
In this review, we summarize the current knowledge about roflumilast cream for the treatment of psoriasis, highlighting its efficacy and safety profile from published clinical trials. Roflumilast's mechanism of action and pharmacokinetic profile are also discussed.
Positive results were reported across trials with 48% of patients treated with roflumilast achieving an Investigator Global Assessment score of clear or almost clear at 8 weeks in phase III studies. Most adverse events were mild or moderate in severity and few application-site reactions were reported among participants. Unique advantages of the cream are its success in treating intertriginous areas and its ability to reduce symptoms of itch, results of which may significantly improve quality of life for patients. In the future, real-world data and active comparator trials with existing non-steroidal agents are needed to better understand roflumilast's place in the current treatment landscape.
治疗银屑病需要新型非甾体类局部用药。0.3%的罗氟司特乳膏是一种每日一次的磷酸二酯酶-4抑制剂,最近已获美国食品药品监督管理局(FDA)批准用于治疗青少年和成人的斑块状银屑病。它适用于包括间擦部位在内的所有身体表面。
在本综述中,我们总结了目前关于罗氟司特乳膏治疗银屑病的知识,重点介绍了已发表临床试验中它的疗效和安全性。还讨论了罗氟司特的作用机制和药代动力学特征。
各项试验均报告了阳性结果,在III期研究中,48%接受罗氟司特治疗的患者在8周时达到研究者整体评估得分为清除或几乎清除。大多数不良事件的严重程度为轻度或中度,参与者中报告的用药部位反应较少。该乳膏的独特优势在于其成功治疗间擦部位的能力以及减轻瘙痒症状的能力,这些结果可能会显著改善患者的生活质量。未来,需要真实世界数据以及与现有非甾体类药物进行活性对照试验,以更好地了解罗氟司特在当前治疗格局中的地位。