Efficacy and safety of oral roflumilast for moderate-to-severe psoriasis—a randomized controlled trial (PSORRO)

Attenuated effects of topical vinpocetine in an imiquimod-induced mouse model of psoriasis

“…PDE inhibition increases cGMP and cAMP levels, and attenuates psoriasiform-like lesions by decreasing key immunostimulatory molecules, notably IL-17, IL-23, and TNF-α. 142 , 143 , 144 …”

Phosphodiesterase-4 Inhibition in the Management of Psoriasis

“…The ease of use with once daily dosing and applicability to all involved areas (body and intertriginous areas) provides a convenient topical solution for patients likely due to the differences in barrier dysfunction in eczematous and psoriatic skin. More recent reports have explored the application of oral roflumilast for psoriasis with significant improvements, albeit with some gastrointestinal side effects which may limit its use [ 48 ]. Roflumilast 0.3% foam was also investigated for scalp and body psoriasis, exhibiting substantial relief and success rates compared to vehicle foam [ 46 ].…”

“…Gyldenløve et al (2023) recently reported the results of the PSORRO trial, a phase 2 multicenter, randomized, double-blinded, placebo-controlled trial (NCT04549870) involving 46 patients [ 48 ]. This study expanded the scope of roflumilast’s exploration in psoriasis by administering roflumilast orally at a dose of 500 µg once daily.…”

“…This safety and efficacy profile persisted over 24 weeks. Common side effects, including transient gastrointestinal symptoms, weight loss, headache, and insomnia, led to the discontinuation of therapy in three patients [ 48 ].…”

“…Formulation, doseOral: 30 mg twice daily Topical: 0.3% once daily to affected areas Oral: 500 mcg once daily Topical: 0.5% or 2% once daily to affected areas Adverse events Nausea, vomiting, diarrhea, headache, nasopharyngitis, dyspepsia, upper respiratory tract infection, loss of appetite, weight loss[27][28][29][30]32,33,[35][36][37][38]41] Application site erythema/pain, nasopharyngitis, upper respiratory tract infection, muscle strain, gastrointestinal symptoms, weight loss, headache, insomnia[46][47][48]50,51] …”