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Repurposing Old Drugs: Roflumilast as a Promising Therapeutic Option for Plaque Psoriasis
Shan Li1, Naichao Wu1, Xingren Liu1
1Department of Dermatology, The 78th Group Army Hospital of the Chinese PLA, Mudanjiang, People's Republic of China.
Background:
Pathogenic studies have revealed that phosphodiesterase 4 (PDE4) plays a key role in psoriasis inflammation. This narrative review evaluates roflumilast, a potent PDE4 inhibitor available in oral and topical formulations, as a repurposed therapeutic for plaque psoriasis.
Objective:
To synthesize the mechanism of action, efficacy, safety, and clinical application of roflumilast, highlighting recent evidence and its position relative to existing therapies.
Methods:
We systematically searched PubMed, Scopus, Web of Science, and Cochrane Library from inception to early 2026 using keywords including "roflumilast", "PDE4 inhibitor", and "plaque psoriasis".
Results:
Both oral and topical formulations achieve clinically meaningful improvements in PASI and IGA scores with favorable tolerability.
Conclusion:
Roflumilast represents a convenient, cost-effective, and practical option, especially for sensitive sites and comorbid patients, although larger head-to-head trials against biologics are still needed.
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