26 Aprile 2022
K Ikumi, K Torii, Y Sagawa, Y Kanayama, A Nakada, H Nishihara, A Morita

Phosphodiesterase 4 inhibitor apremilast improves insulin resistance in psoriasis patients

J Dermatol. 2022 Apr;49(4):e125-e126

Key messages

  • La psoriasi si associa ad un rischio elevato di diabete mellito e il presente studio ha indagato l’effetto di apremilast sull’insulino-resistenza nei pazienti giapponesi con psoriasi.
  • Il trattamento con l’inibitore della fosfodiesterasi 4 riduce i livelli sierici di insulina a digiuno nei pazienti con psoriasi affetti da insulino-resistenza.


Psoriasis is associated with a high risk of diabetes mellitus. We previously reported that the Psoriasis Area and Severity Index (PASI) correlates with hemoglobin A1c (HbA1c) levels in psoriasis patients treated with biologics. Treatment with interleukin-17 decreases HbA1c levels. Cyclic adenosine monophosphate (cAMP) is an important second messenger in the immune and metabolic systems. The phosphodiesterase inhibitor (PDEI) roflumilast, which acts by increasing cAMP, is reported to improve insulin homeostasis and obesity. Several studies have demonstrated that another PDEI, apremilast, improves obesity, but does not improve blood glucose levels. Here, we investigated the effect of apremilast on insulin resistance in Japanese patients with psoriasis.

Previous reports indicated that PDE4 inhibitors affect glucose metabolism, and the present report extends these findings to show that treatment with a PDE4 inhibitor reduces fasting serum insulin levels in psoriasis patients with insulin resistance. Furthermore, fasting serum insulin levels and HOMA-IR, an indicator of insulin resistance, were higher in psoriasis patients than the reference values. In conclusion, insulin resistance in patients with psoriasis may be improved by treatment with the PDE4 inhibitor apremilast.

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