Characteristics and outcomes of patients treated with apremilast in the real world: results from the APPRECIATE study

Abstract

BackgroundAPPRECIATE is a multinational, observational, retrospective, cross‐sectional study in patients treated for psoriasis with apremilast, an oral phosphodiesterase 4 inhibitor.ObjectivesTo describe the characteristics of patients with psoriasis treated with apremilast in the clinical setting, to evaluate real‐world outcomes of psoriasis treatment with apremilast and to better understand the perspectives of patients and physicians on treatment outcomes.MethodsIn six European countries, patients with chronic plaque psoriasis treated in clinical practice who could be contacted 6 (±1) months after apremilast initiation were enrolled. Patient characteristics, Dermatology Life Quality Index (DLQI) and Psoriasis Area and Severity Index (PASI) were obtained from medical records when available. Outcomes were evaluated using patient/physician questionnaires.ResultsIn 480 patients at treatment initiation, mean [median; 95% confidence interval (CI)] PASI and DLQI scores were 12.5 (10.7; 11.6–13.4) and 13.4 (13.0; 11.4–14.2), respectively. At 6 (±1) months, 72.3% of patients (n = 347) continued apremilast treatment [discontinuations: lack of efficacy (13.5%), safety (11.7%), other (2.5%)]. In patients continuing treatment, 48.6% achieved a ≥75% reduction in PASI score; mean (95% CI) DLQI score was 5.7 (4.5–6.9), and mean (SD) Patient Benefit Index score was 2.8 (1.2). Physicians perceived clinical improvement in 75.6% of patients. Physicians’ perspective on overall success of apremilast in meeting expectations correlated with patients’ perception of treatment benefit (r = 0.691). Most commonly reported adverse events (>5% of patients) were diarrhoea, nausea and headache.ConclusionsPatients in APPRECIATE reported high disease burden despite more moderate skin involvement than those who enrolled in clinical trials of apremilast. Findings from APPRECIATE demonstrate the real‐world value of apremilast for psoriasis treatment, as 7 of 10 patients continued therapy and showed notable improvement in disease severity and quality of life 6 (±1) months after apremilast initiation.

Apremilast Pharmacogenomics in Russian Patients with Moderate-to-Severe and Severe Psoriasis

“…It should be noted that the effectiveness of therapy in this study was slightly lower than in international clinical trials and real-world studies [ 61 , 62 , 63 , 64 , 65 ]. So, 44% of patients did not reach PASI 50 by 14 weeks, and by 26 weeks—47%.…”

Long-Term Proactive Treatment of Plaque Psoriasis with Calcipotriene/Betamethasone Dipropionate Foam Prolongs Remission and Reduces Relapses Irrespective of Patient Baseline Characteristics

“…Patients with psoriasis often present with comorbid conditions and have a variety of detrimental characteristics (e.g., obesity, severity of disease, long duration of disease) that can negatively affect treatment outcomes [8]. Analysis of baseline characteristics related to treatment outcome was reported for psoriasis systemic treatments (oral and biologic) [2,3]. However, such data have not yet been produced for topical treatments as Cal/BD foam is the first drug receiving a label for longterm treatment.…”

“…The influence of patient characteristics on treatment outcome was studied in the moderate-to-severe patient population treated with systemic therapies (either orals or biologics). Thus far, long-term results from the use of topical therapies are lacking [2,3].…”

Apremilast Uses and Relevance to the Military

“…Furthermore, the mean dermatology life quality index (DLQI) score of the surveyed population decreased from 13.4 at initiation of treatment to 5.7 at 6 (1) months of treatment-a marked improvement in quality of life. 12 Other single-center and smaller study populations also have suggested increased realworld benefit. 13,14 Nonetheless, the rate and degree of clearance of plaques with apremilast seem to lag behind what is observed with many of the biologics and traditional medications employed to treat psoriasis.…”