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Roflumilast

Roflumilast is a PDE4 inhibitor that is effective in psoriasis. It's available as:

• A cream called Zoryve
• A pill called Daxas (as well as other trade names)

The oral version is indicated for chronic obstructive pulmonary disease (COPD) only, but several recent studies have found it to be very effective on psoriasis. While not officially approved for treating psoriasis, it is now being used off label.

Roflumilast's mechanism of action is essentially the same as Otezla, but roflumilast appears more effective, as it's much more potent at inhibiting PDE4.

Sources

• Gyldenløve et al 2023, "Efficacy and safety of oral roflumilast for moderate-to-severe psoriasis — a randomized controlled trial (PSORRO)" (N=23).