25602 Improvements and response achievement in PASI subscale domains for head scaling and erythema in apremilast-treated patients with moderate to severe plaque psoriasis of the scalp: Results from the STYLE study
Papp K, Van Voorhees A, Gold LS, Lebwohl M, Strober B, Zhang Z, and Wang Y. 25602 Improvements and response achievement in PASI subscale domains for head scaling and erythema in apremilast-treated patients with moderate to severe plaque psoriasis of the scalp: Results from the STYLE study. J Am Acad Dermatol 2021; 85(3):AB63.
J Am Acad Dermatol
Background: Up to 80% of patients with psoriasis have scalp involvement. Apremilast 30 mg BID (APR) demonstrated efficacy in the phase 3 STYLE study of moderate-to-severe scalp psoriasis. We report a post hoc analysis of the head scaling and head erythema PASI subscale domains.
Methods: Patients with moderate-to-severe plaque psoriasis (PASI ≥12, BSA ≥10%, sPGA ≥3) and moderate-to-severe scalp psoriasis (baseline Scalp PGA score ≥3, psoriasis-involved scalp surface area ≥20%) with inadequate response/intolerance to ≥1 topical therapy were randomized to double-blind treatment with APR or placebo (PBO) for 16 weeks.
Results: Baseline mean (SD) PASI head scaling scores were 2.8 (0.7) for APR (n = 201) and PBO (n = 102); head erythema scores were 2.9 (0.6) and 2.8 (0.6). Significantly greater mean percentage changes from baseline were observed at Week 16 with APR vs PBO in head scaling (APR: −52.2 [95% CI: −57.9, −46.4] vs PBO: −26.9 [95% CI: −34.4, −19.4]) and head erythema scores (APR: −53.1 [95% CI: −59.1, −47.2] vs PBO: −25.0 [95% CI: −32.0, −17.9]). Improvements were observed as early as Week 2. Significantly more APR vs PBO patients achieved Week 16 responses (score of 0 [none] or 1 [slight]) on head scaling (55.4% [95% CI: 47.5, 63.0] vs 31.0% [95% CI: 21.3, 42.0]; P =.0002) and erythema (55.4% [95% CI: 47.5, 63.0] vs 23.8% [95% CI: 15.2, 34.3]; P ˂.0001).
Conclusions: Patients with moderate-to-severe scalp psoriasis had greater improvements in PASI subscale scores (head scaling, head erythema); greater proportions of patients achieved head scaling and erythema responses with APR vs PBO.