Apremilast as a treatment for morphea: A case series

Koschitzky, Merav; Khattri, Saakshi

doi:10.1016/j.jdcr.2021.11.009

Cited by 10 publications

(4 citation statements)

References 7 publications

(8 reference statements)

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“…me for clinical improvement was 1 month. 33 There was decrease in modifi ed localized Scleroderma Skin Severity Index (mLOSSI) and modifi ed localized Scleroderma Skin Damage Index (mLOSDI), although the signifi cance was not commented upon. There was no new development of lesions a# er 1 month of treatment.…”

Section: Morpheamentioning

confidence: 99%

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Non-FDA-Approved Uses of Apremilast in Dermatology: A Review of Current Available literature

Bhatia¹

2022

Nepal J Dermatol Venereol & Leprol

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Introduction: Apremilast, an oral phosphodiesterase-4 inhibitor, decreases the production of pro-inflammatory cytokines including tumour necrosis factor-α, interleukin-12/23, IL-12, IL-2, and interferon-γ; while upregulating the anti-inflammatory cytokine IL-10. Its pan-immunomodulatory nature has led to its use in managing various immune-mediated dermatoses for non-FDA-approved indications. Objectives: To review and analyze the use of Apremilast in Non-FDA-approved indications in current available literature. Materials and methods: PubMed, EMBASE, SCOPUS, and Google scholar databases were searched with the parameters “Apremilast”, “Apremilast NOT Psoriasis*”, “Apremilast NOT Behçet’s*”, and “Apremilast NOT arthritis*”. A total of 45 relevant articles were chosen for review. Results: We found 22 indications in dermatology where apremilast has been used without FDA approval. The best evidence was for treatment in Atopic Dermatitis, Alopecia Areata, and Hidradenitis Suppurativa, with randomized controlled trials. Prospective open-label trials were found for Cutaneous Sarcoidosis, Lichen Planus, Rosacea, and Vitiligo. Individual case series and reports were found for Acrodermatitis Continua of Hallopeau, Dermatomyositis, Disseminated Granuloma Annulare, Erythema Nodosum Leprosum, Morphea, Pityriasis Rubra Pilaris, Hailey-Hailey Disease, Recurrent Erythema Multiforme, and Folliculitis Decalvans, Prurigo Nodularis, Perforating Dermatoses, Chronic Actinic Dermatitis, and Hand Eczema, and Epidermolysis Bullosa Simplex-Generalised Severe Type. Apremilast has shown varied efficacy despite a better safety profile and tolerability over a long duration compared to conventional immunosuppressant drugs and placebo. Conclusion: Apremilast has been used for varied non-FDA-approved indications in dermatology with variable efficacy. Better controlled, randomized studies with adequate sample size and drug comparisons are needed for better analyses.

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Section: Morpheamentioning

confidence: 99%

“…ng that it may provide some benefi t in scleroderma disorders like morphea or localized scleroderma. 33 Koschitzky M et al, have reported the use of Apremilast 30mg twice a day along with topical super-potent steroids or topical calcineurin inhibitor in 5 pa! ents of Morphea inadequately improving with oral steroids or steroid sparing agents.…”

Section: Morpheamentioning

confidence: 99%

Non-FDA-Approved Uses of Apremilast in Dermatology: A Review of Current Available literature

Bhatia¹

2022

Nepal J Dermatol Venereol & Leprol

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“…Numerous other systemics have been reported in LS, including tocilizumab, Janus kinase (JAK) inhibition, intravenous immunoglobulins rituximab, cyclosporine A, apremilast, azathioprine and infliximab. [53][54][55][59][60][61][62][63][64][65] These treatments should be reserved to single severe cases with contraindications or failure to standard therapy.…”

Section: Other Immunosuppressive or Immune Modulating Approachesmentioning

confidence: 99%

Consensus statement on the diagnosis and treatment of sclerosing diseases of the skin, Part 1: Localized scleroderma, systemic sclerosis and overlap syndromes

Knobler,

Geroldinger‐Simić,

Kreuter

et al. 2024

Acad Dermatol Venereol

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The term ‘sclerosing diseases of the skin’ comprises specific dermatological entities, which have fibrotic changes of the skin in common. These diseases mostly manifest in different clinical subtypes according to cutaneous and extracutaneous involvement and can sometimes be difficult to distinguish from each other. The present consensus provides an update to the 2017 European Dermatology Forum Guidelines, focusing on characteristic clinical and histopathological features, diagnostic scores and the serum autoantibodies most useful for differential diagnosis. In addition, updated strategies for the first‐ and advanced‐line therapy of sclerosing skin diseases are addressed in detail. Part 1 of this consensus provides clinicians with an overview of the diagnosis and treatment of localized scleroderma (morphea), and systemic sclerosis including overlap syndromes.

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“…Various case reports and case series have documented successful use of apremilast in morphoea, 55 palmoplantar keratoderma, 56 orofacial granulomatosis, 57 recalcitrant seborrhoeic dermatitis, 58 recurrent erythema multiforme 59 and epidermolysis bullosa simplex (generalized severe) 60 . A detailed summary of these case series is presented in Table 11.…”

Section: Off‐label Dermatological Uses Of Apremilastmentioning

confidence: 99%

Evolving utility of apremilast in dermatological disorders for off-label indications

Mehta

Sharma

Dogra

2022

Clinical and Experimental Dermatology

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Apremilast, a small molecule that acts by inhibition of the phosphodiesterase‐4 enzyme, has been approved by the US Food and Drug Administration for the management of psoriatic arthritis, plaque psoriasis and Behçet disease. The drug has drawn much interest from practising dermatologists in view of its exceptional safety profile and prescription convenience, as evident by the recent surge of literature describing its off‐label indications. This review was carried out with the aim of summarizing the literature on off‐label use of apremilast in dermatology, in order to guide clinicians regarding currently available evidence. The PubMed database was searched using ‘apremilast’ as a keyword in the title. Abstracts were individually screened to determine whether there was a description of an off‐label use of apremilast in dermatology within the article. Randomized controlled trial data were available for vitiligo, alopecia areata, hidradenitis suppurativa and atopic dermatitis. Case series and case reports describing apremilast were also reviewed. Owing to its broad spectrum of immunomodulatory activity, apremilast may be useful in several chronic inflammatory skin diseases recalcitrant to conventional therapies, either alone or in combination with other drugs. Further studies are needed to establish its role in various dermatological indications.

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Apremilast as a treatment for morphea: A case series

Cited by 10 publications

References 7 publications

Non-FDA-Approved Uses of Apremilast in Dermatology: A Review of Current Available literature

Non-FDA-Approved Uses of Apremilast in Dermatology: A Review of Current Available literature

Consensus statement on the diagnosis and treatment of sclerosing diseases of the skin, Part 1: Localized scleroderma, systemic sclerosis and overlap syndromes

Evolving utility of apremilast in dermatological disorders for off-label indications

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