Final answer:
Otezla (apremilast) does not require TB screening prior to treatment initiation, in contrast to biologics like Stelara, Cosentyx, and Humira, due to its different mechanism of action which does not suppress the immune system as extensively.
Step-by-step explanation:
Among the psoriasis medications listed, Otezla (apremilast) does not require screening for tuberculosis (TB) prior to starting treatment. Unlike the other medications mentioned which are biologics, Otezla works by inhibiting an enzyme called phosphodiesterase 4 (PDE4), and does not suppress the immune system to the same extent as biologics, which target specific pathways or cells of the immune system. This difference in the mechanism of action is why TB screening is not a prerequisite for Otezla, while it is generally recommended for biologics like Stelara (ustekinumab), Cosentyx (secukinumab), and Humira (adalimumab) because of their immunosuppressive effects.