From 1 January 2021, apremilast is available on the Pharmaceutical Benefits Scheme (PBS). Apremilast is PBS listed for the treatment of severe chronic plaque psoriasis that has a significant effect on quality of life. Patients must be unable to take methotrexate or have achieved an inadequate response following at least six weeks of methotrexate therapy.

Apremilast is a phosphodiesterase 4 (PDE4) inhibitor. Inhibition of PDE4 increases cyclic adenosine monophosphate (cAMP), an important regulator of innate and adaptive immune functions. The result is reduced production of inflammatory cytokines such as interleukin (IL)-17, IL-23, and tumour necrosis factor-alpha (TNF-α), and an increase in anti-inflammatory mediators such as IL-10.

The safety and efficacy of apremilast were studied in the ESTEEM-2 trial. Significantly more patients in the apremilast group achieved ≥75% improvement in their Psoriasis Area and Severity Index (PASI) score compared to placebo (28.8% versus 5.8%). The mean change in PASI score was -50.9% for apremilast compared to -15.8% for placebo. The most commonly reported adverse events were diarrhoea and nausea. The apremilast dosing schedule includes an initial titration period which is intended to minimise gastrointestinal adverse effects.


  1. Otezla® (Apremilast) Australian approved product information. North Ryde: Amgen Australia. Approved June 2020.
  2. Paul C, Cather J, Gooderham M, Poulin Y, Mrowietz U, Ferrandiz C, et al. 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). Br J Dermatol. 2015; 176(6): 1387-99.

Subscribe Knowledge Centre Updates

Enter your details to receive Knowledge Centre updates