Otezla is a novel, orally available small molecule inhibitor of type-4 cyclic nucleotide phosphodiesterase (PDE -4). It is indicated in the treatment of active psoriatic arthritis in adults (approved by the FDA in March 2014) and moderate to severe plaque psoriasis (approved by the FDA in September 2014). PDE -4 is a cyclic adenosine monophosphate (cAMP)-specific phosphodiesterase that is predominantly located in inflammatory cells. By inhibiting PDE -4, otezla increases intracellular levels of cAMP and thereby inhibits the production of multiple proinflammatory mediators including PDE -4, TNF -alpha, interleukin-2 (IL-2), interferon-gamma, leukotrienes, and nitric oxide synthase. By targeting a central component of the inflammatory signaling cascade rather than a single inflammatory marker, PDE -4 inhibition may restore the homeostatic balance between pro- and anti-inflammatory signalling.
DEPRESSION AND SUICIDE: Otezla has been associated with increased depression and suicidal behaviour in patients. WEIGHT LOSS: Otezla has been associated with weight decrease in patients.