Efficacy of Apremilast in Patients with Mild to Moderate Psoriasis Involving the Scalp and Nails: A Post Hoc Analysis of the Phase 3 Advance Study

Document Type

Conference Proceeding

Publication Date

7-1-2026

Publication Title

J Am Acad Dermatol

Keywords

Dermatology

Abstract

Psoriasis in high-impact sites such as the scalp and nails can significantly impact quality of life, even with limited skin involvement.(1,2) ADVANCE was a randomized, placebo-controlled, double-blind study in biologic-naive adults with mild to moderate psoriasis (static Physician Global Assessment 2-3, psoriasis-involved body surface area [BSA] 2-15%, and Psoriasis Area and Severity Index [PASI] 2-15) inadequately controlled by/intolerant to topical therapy. Patients were randomized 1:1 to apremilast or placebo for 16 weeks, after which all patients received apremilast through Week 32. This post hoc analysis assessed 130 patients with both scalp and nail involvement at baseline (scalp Physician Global Assessment [ScPGA] ≥ 2 and Nail Psoriasis Severity Index [NAPSI] >0: apremilast, n=58; placebo, n=72). Baseline mean age 49.7 years, 70% male, mean BSA 6.8%, mean PASI 7.3, 39.2% ScPGA=2 and 60.8% ScPGA ≥ 3, mean NAPSI 3.5, and mean Dermatology Life Quality Index (DLQI) 9.7; characteristics were balanced between treatment arms. At Week 16, more apremilast than placebo patients achieved ≥ 75% reduction in BSA (32.8% vs 4.2%), BSA ≤ 3% (in patients with baseline BSA >3%; 56.0% vs 18.8%), ≥ 75% reduction in PASI (27.6% vs 2.8%), PASI <3 (in patients with baseline PASI ≥ 3; 44.6% vs 9.0%), ScPGA score 0/1 with ≥ 2-point reduction from baseline (43.1% vs 12.5%), NAPSI=0 (34.5% vs 13.9%), and ≥ 4-point reduction in DLQI (in patients with baseline DLQI ≥ 4; 56.3% vs 35.0%). Response rates were maintained/increased through Week 32 with continued apremilast; patients who transitioned from placebo to apremilast at Week 16 achieved similar responses by Week 32.

Volume

95

Issue

1

First Page

AB190

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