Efficacy and safety of apremilast, an oral phosphodiesterase 4 inhibitor, in ankylosing spondylitis

Pathan, Ejaz; Abraham, Sonya; Rossen, Elizabeth Van; Withrington, R. H.; Keat, Andrew; Charles, Peter; Paterson, Erin; Chowdhury, M. I. Sakib; McClinton, Catherine; Taylor, Peter

doi:10.1136/annrheumdis-2012-201915

Cited by 116 publications

(63 citation statements)

References 32 publications

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“…1,2,8 Apremilast is a novel, orally available small molecule that inhibits the activity of PDE4, subsequently inhibiting the production of TNF-alpha, IL-2, IL-8, IL-12, IL-23, CXCL9, CXCL10, CCL4, interferongamma, and leukotriene B4 and increasing the production of IL-10. [1][2][3][4][5][8][9][10] The specifi c mechanism(s) by which apremilast exerts its therapeutic action in psoriatic arthritis patients is not well defi ned. 1 Apremilast also suppresses arthritis in rodents and reduces the severity of psoriasiform features in mice with psoriatic xenografts.…”

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confidence: 99%

Apremilast

2014

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Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are sent in print and are also available on-line. Monographs can be customized to meet the needs of a facility. A drug class review is now published monthly with The Formulary Monograph Service. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, call The Formulary at 800-322-4349. The September 2014 monograph topics are tedizolid phosphate, ceritinib, omega-3-carboxylic acids, umeclidinium bromide inhalation powder, and siltuximab. The DUE/MUE is on avoidance of insulin use errors.

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Apremilast

2014

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“…Recently, large double-blind and randomized multicenter studies demonstrated that APM is effective in the treatment of psoriasis, PsA, and AS, with significantly higher numbers of patients achieving the endpoints compared with baseline [Pathan et al 2013;Schett et al 2012]. Anakinra (ANK) (IL-1 receptor antagonist) has been approved for active RA patients and it is useful in many inflammatory diseases [Néel et al 2014;Cantarini et al 2014].…”

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Pharmacological treatment of spondyloarthritis: exploring the effectiveness of nonsteroidal anti-inflammatory drugs, traditional disease-modifying antirheumatic drugs and biological therapies

Caso

Costa

Puente

et al. 2015

Therapeutic Advances in Chronic Disease

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Spondyloarthritis represents a heterogeneous group of articular inflammatory diseases that share common genetic, clinical and radiological features. The therapy target of spondyloarthritis relies mainly in improving patients' quality of life, controlling articular inflammation, preventing the structural joints damage and preserving the functional abilities, autonomy and social participation of patients. Among these, traditional disease-modifying antirheumatic drugs have been demonstrated to be effective in the management of peripheral arthritis; moreover, in the last decade, biological therapies have improved the approach to spondyloarthritis. In patients with axial spondyloarthritis, tumor necrosis factor α inhibitors are currently the only effective therapy in patients for whom conventional therapy with nonsteroidal anti-inflammatory drugs has failed. The aim of this review is to summarize the current experience and evidence about the pharmacological approach in spondyloarthritis patients.

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“…The IL-6R antagonists tocilizumab and sarilumab [14,15] do not seem to work in AS. In contrast, the anti-IL 17a-antibody secukinumab [16] and the phosphodiesterase-4 inhibitor apremilast may have beneficial effects in AS [17]. On the other hand, in the first reports about the pharmacokinetics, the efficacy and safety of biosimilars in patients with active AS have shown promising results [18].…”

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Biologic Therapies for Spondyloarthritis: What Is New?

Baraliakos

Braun

2012

Curr Rheumatol Rep

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The course of axial spondyloarthritis (axSpA), including ankylosing spondylitis (AS), is strongly influenced by the degree of disease activity over time, which is mainly based on inflammation, and by the impairment of function, which is based on structural damage-mainly, new bone formation-and inflammation. In AS, nonsteroidal anti-inflammatory agents are currently recommended as the first choice of medical therapy, and there is also a clear role for regular exercise and physiotherapy in order to preserve and prevent loss of spinal mobility. For patients who have insufficiently responded to conventional medications, there are now four biologics approved for the treatment of patients with active AS in many countries, all directed against TNFα: infliximab, etanercept, adalimumab, and golimumab; studies with certolizumab are currently ongoing. Several studies with patients classified as nonradiographic axSpA have also shown a good response to TNF blockers; in patients with early disease and high CRP levels, the response rates were even better. Long-term studies with TNF blockers have shown declining retention rates over time but sustained clinical efficacy in the patients who remained on treatment. States of drug-free remission are rarely reached and only for relatively short periods of time. More studies including magnetic resonance imaging (MRI) are needed to further examine the lack of effect of anti-TNF treatment on radiographic progression in the axial skeleton. Whether the effect of an early intervention with biologics will prevent the development of bone growth in patients with nonradiographic axial SpA remains to be seen. Biologics other than TNF blockers are currently not recommended for the treatment of patients with axSpA, because of insufficient evidence of clinically relevant efficacy. The anti-IL-17a antibody secukinumab may be efficacious, on the basis of a proof-of-concept trial. Finally, first data on biosimilars of TNF blockers have recently been presented.

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Efficacy and safety of apremilast, an oral phosphodiesterase 4 inhibitor, in ankylosing spondylitis

Abstract: Although a small pilot study, these results suggest that apremilast may be effective and well tolerated in AS and modulates biomarkers of bone biology. These data support further research of apremilast in axial inflammation.

Cited by 116 publications

References 32 publications

Apremilast

Apremilast

Pharmacological treatment of spondyloarthritis: exploring the effectiveness of nonsteroidal anti-inflammatory drugs, traditional disease-modifying antirheumatic drugs and biological therapies

Biologic Therapies for Spondyloarthritis: What Is New?

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