Apremilast: A Review in Psoriasis and Psoriatic Arthritis

Keating, Gillian M.

doi:10.1007/s40265-017-0709-1

Cited by 146 publications

(99 citation statements)

References 47 publications

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“…Though numerous psoriasis treatments are available, few are convenient and long‐term safe; and even if sufficiently effective, troublesome treatments themselves often decrease QOL and make long‐term adherence difficult. Apremilast is a new, oral, small‐molecule phosphodiesterase‐4 inhibitor that regulates various cytokine levels related to psoriasis, including interleukin‐17, by increasing intracellular cyclic adenosine monophosphate (cAMP) levels . In Japan, apremilast was approved in December 2016, and was expected to be a simple and long‐lasting systemic therapeutic agent.…”

Section: Introductionmentioning

confidence: 99%

Real‐world experiences of apremilast in clinics for Japanese patients with psoriasis

Saruwatari¹

2019

The Journal of Dermatology

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Psoriasis, though not an immediately life‐threatening disorder, still lowers quality of life and disrupts daily functions. While many treatments for psoriasis exist, few are convenient and safe long term; even if sufficiently effective, treatments themselves often decrease quality of life and make long‐term treatment adherence difficult. Approved in Japan in December 2016, apremilast was expected to function as a simple, long‐term, systemic therapeutic agent for psoriasis. We report on the clinical outcomes of administrating apremilast for 2 years as observed in 46 psoriatic patients at the Saruwatari Dermatology Clinic between March 2017 and February 2019. We believe the ease of clinic consultation (as compared with large general hospital consultation) draws patients who are busy or have mild symptoms, and consequently poor adherence to regular visits and treatment, reflecting realistic conditions. Major adverse events with apremilast treatment were diarrhea (37.0%) and nausea (15.3%), with most cases of diarrhea being mild. Drug survival analysis by the Kaplan–Meier method revealed a 1‐year continuation rate of 46.8% and a 2‐year continuation rate of 37.4%. Dermatology Life Quality Index (DLQI) scores during the observation period declined from 9.3 to 2.8 (P < 0.0001) on average, with the DLQI‐0/1 achievement rate being 28.6%. Based on our findings, we conclude that apremilast is suitable as a long‐lasting basic treatment that is easy to prescribe in small clinics and easy to use in everyday life.

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Section: Introductionmentioning

confidence: 99%

Real‐world experiences of apremilast in clinics for Japanese patients with psoriasis

Saruwatari¹

2019

The Journal of Dermatology

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“…Apremilast is a novel oral small-molecule phosphodiesterase 4 inhibitor that regulates the production of pro-inflammatory mediators such as tumor necrosis factor-a, c-interferon, interleukin (IL)-17 and IL-23 by increasing intracellular cyclic adenosine monophosphate levels. 1 Apremilast was approved by the US Food and Drug Administration in 2014 and by the European Medicines Agency in 2015. 2 In Japan, it was approved in December 2016 for moderate to severe plaque psoriasis and active psoriatic arthritis (PsA).…”

Section: Introductionmentioning

confidence: 99%

Real‐world use of apremilast for patients with psoriasis in Japan

Kishimoto

Komine

Hioki

et al. 2018

The Journal of Dermatology

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Apremilast is a novel oral phosphodiesterase 4 inhibitor effective for psoriasis. It regulates the production of pro-inflammatory mediators. Apremilast was approved in December 2016 in Japan; however, its efficacy and safety in a real-world setting among Japanese patients have not been reported. We report on 44 patients treated with apremilast between March and October 2017. The median treatment duration was 25 weeks (range, 2-33). Thirty-five patients (79.5%) continued the drug for at least 23 weeks, and five (11.4%) achieved a Psoriasis Area and Severity Index 100 response within 12 weeks. Nine patients discontinued the drug within 24 weeks mainly due to insufficient efficacy (n = 3) and adverse events (n = 4). Seven patients continued their previous systemic therapies such as cyclosporin (n = 1), methotrexate (n = 1), etretinate + methotrexate (n = 1) and biologics (n = 4) combined with apremilast. Of these patients, 55.9% had at least one adverse event although no severe adverse events. The most common adverse event was diarrhea (31.8%), followed by nausea (25.0%), headache (13.6%), abdominal discomfort (6.8%) and vomiting (6.8%). The proportion of diarrhea in our patients was higher than those of previous clinical trials. Among 10 patients with psoriatic arthritis, apremilast did not improve joint pain in nine (90%). To investigate the relationship between treatment efficacy and plaque size, we defined a small plaque as an individual rash diameter of 1 inch or less. The efficacy of apremilast was greater in patients with small plaques than in patients with large plaques.

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“…ACH is usually refractory to therapy, although biological treatments such as secukinumab and ustekinumab have shown promising results (Muggli, Maul, Anzengruber, Fopp, & Navarini, ). Apremilast is an oral phosphodiesterase 4 (PDE4) inhibitor, approved for the treatment of chronic plaque psoriasis and psoriatic arthritis (Keating, ). Moreover, recently, Apremilast has shown hopeful results in treating nail psoriasis and refractory palmoplantar pustulosis (Georgakopoulos, Ighani, & Yeung, ).…”

Section: Discussionmentioning

confidence: 99%

Nails as immune‐privileged sites: A case of disabling Acrodermatitis continua of Hallopeau successfully treated with Apremilast

Lanna

Cesaroni

Mazzilli

et al. 2019

Dermatologic Therapy

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Acrodermatitis continua of Hallopeau (ACH) is a chronic, inflammatory, and relapsing disorder characterized by the progressive destruction of fingernails and toenails. This condition is rare, difficult to treat, and often misdiagnosed. Several antipsoriatic treatments have been used, without any therapeutic guideline and no real improvement. Apremilast is an oral phosphodiesterase 4 inhibitor, approved for the treatment of chronic plaque psoriasis and psoriatic arthritis. It increases the intracellular concentration of cAMP and restores cytokine equilibrium, especially IL‐10, which is particularly involved in nail psoriasis. We reported the case of a 58‐year‐old man affected by ACH, successfully treated with Apremilast, who achieved a complete healing in just 1 month of treatment without any side effect. We suggest this drug as a successful new treatment for ACH, which can improve clinical manifestations rapidly and has no or few adverse effects. Future formal clinical trials and additional case reports are needed to establish the safety and efficacy of Apremilast in the treatment of ACH.

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Apremilast: A Review in Psoriasis and Psoriatic Arthritis

Cited by 146 publications

References 47 publications

Real‐world experiences of apremilast in clinics for Japanese patients with psoriasis

Real‐world experiences of apremilast in clinics for Japanese patients with psoriasis

Real‐world use of apremilast for patients with psoriasis in Japan

Nails as immune‐privileged sites: A case of disabling Acrodermatitis continua of Hallopeau successfully treated with Apremilast

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