Complete clearance of severe plaque psoriasis with 24 weeks of oral roflumilast therapy

Current psoriasis therapies have little-to-no effect on comorbidities such as obesity and chronic obstructive pulmonary disease (COPD). Apremilast, a phosphodiesterase 4 (PDE-4) inhibitor, is approved for moderate-to-severe psoriasis and considered a safe treatment option, that does not require laboratory monitoring. Nonetheless, lower efficacy compared with novel similar priced biologics, have led to modest use of apremilast in some countries. Roflumilast, a selective oral PDE-4 inhibitor, is approved for severe COPD in the US and EU. A common side effect of roflumilast therapy is weight loss, which has limited its use in COPD, where underweight is frequently observed.