Real life experience of apremilast in psoriasis and arthritis psoriatic patients: Preliminary results on metabolic biomarkers

Mazzilli, Sara; Lanna, Caterina; Chiaramonte, Carlo; Cesaroni, Gaia Maria; Zangrilli, Arianna; Palumbo, Vincenzo Davide; Cosio, Terenzio; Dattola, Annunziata; Gaziano, Roberta; Galluzzo, Marco; Chimenti, Maria Sole; Gisondi, Paolo; Bianchi, Luca; Campione, Elena

doi:10.1111/1346-8138.15293

Cited by 38 publications

(33 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An interesting study conducted by Mazzilli and coworkers observed a better therapeutic response to apremilast in diabetic patients compared to non-diabetic patients, with a reduction in blood glucose and total-and LDLc levels (94). Based on these findings, apremilast may be an appropriate therapeutic choice in patients with PsO/PsA and MetS (94).…”

Section: Apremilastmentioning

confidence: 94%

“…Apremilast also appears to contribute to counteracting endothelial dysfunction, thus reducing CV risk (91,92), and to stabilize atherosclerotic plaques, hence blocking its evolution to an unstable, high risk phenotype (93). An interesting study conducted by Mazzilli and coworkers observed a better therapeutic response to apremilast in diabetic patients compared to non-diabetic patients, with a reduction in blood glucose and total-and LDLc levels (94). Based on these findings, apremilast may be an appropriate therapeutic choice in patients with PsO/PsA and MetS (94).…”

Section: Apremilastmentioning

confidence: 99%

See 1 more Smart Citation

Psoriatic Arthritis and Metabolic Syndrome: Is There a Role for Disease Modifying Anti-Rheumatic Drugs?

et al. 2021

View full text Add to dashboard Cite

Although psoriatic arthritis (PsA) primarily leads to joint and skin damage, it is associated with higher prevalence of metabolic syndrome (MetS) and its components, namely hypertension, dyslipidemia, obesity, and type II diabetes. Additionally, chronic inflammation is known to aggravate these cardiometabolic factors, thus explaining the enhanced cardiovascular (CV) morbidity and mortality in RA. Furthermore, emerging evidence suggest that some risk factors can fuel inflammation, thus pointing to a bidirectional crosstalk between inflammation and cardiometabolic factors. Therefore, dampening inflammation by disease-modifying anti-rheumatic drugs (DMARDs) may be thought to ameliorate MetS burden and thus, CV risk and disease severity. In fact, recommendations for PsA management emphasize the need of considering comorbidities to guide the treatment decision process. However, the existing evidence on the impact of approved DMARDs in PsA on MetS and MetS components is far from being optimal, thus representing a major challenge for the clinical setting. Although a beneficial effect of some DMARDs such as methotrexate, TNF inhibitors and some small molecules is clear, no head-to-head studies are published and no evidence is available for other therapeutic approaches such as IL-23 or IL-17 inhibitors. This narrative review summarizes the main evidence related to the effect of DMARDs on MetS outcomes in PsA patients and identify the main limitations, research needs and future perspectives in this scenario.

show abstract

Section: Apremilastmentioning

confidence: 94%

Section: Apremilastmentioning

confidence: 99%

Psoriatic Arthritis and Metabolic Syndrome: Is There a Role for Disease Modifying Anti-Rheumatic Drugs?

et al. 2021

View full text Add to dashboard Cite

show abstract

“… 36 , 37 In a study by Mazzilli et al published in 2020, the authors confirmed the efficacy and safety of apremilast in favoring the improvement of skin and joint disease as well as the modulation of metabolic biomarkers in diabetic and non-diabetic psoriatic patients, and concluded that apremilast could be used successfully in psoriatic patients affected by cardiometabolic comorbidities, ensuring an improvement in both diseases. 38 …”

Section: Use Of Apremilast For Plaque Psoriasis In Special Populationsmentioning

confidence: 99%

The Use of Apremilast in Psoriasis: An Indian Perspective on Real-World Scenarios

Rajagopalan¹,

Dogra²,

Saraswat³

et al. 2021

PTT

View full text Add to dashboard Cite

Apremilast, an oral phosphodiesterase-4 inhibitor, is approved for use in the management of psoriasis and psoriatic arthritis. Although its efficacy and safety have been well established in clinical studies, in real-world settings, different practice scenarios have been reported. This review paper serves to evaluate clinical real-world scenarios and aspects of treatment for which the information in the literature was considered to be lacking or controversial. Following a literature review, a panel of five dermatologists with expertise in psoriasis considered five scenarios; namely, the positioning of apremilast in psoriasis, its use in difficult-to-treat areas, special conditions and populations, safety, dose titration and dose in maintenance therapy. These were then assessed with psoriasis experts in India using a web-based questionnaire. A total of 28 questions were discussed regarding these scenarios. According to the responses, apremilast is effective in stable mild to moderate psoriasis as monotherapy and in severe psoriasis in combination. Also, a positive response was received with regard to its effectiveness in difficult locations such as the scalp, palms and soles. To reduce adverse effects, prolonged titration therapy over 4 weeks is required and lower doses can be prescribed to maintain remission. Apremilast therapy should be continued for a minimum of 8 weeks once initiated to achieve the desired results, and the total duration of therapy should be about 24 weeks for better efficacy. It is also effective in many other cases, such as obese patients, patients with hepatitis B or C and HIV, or patients on polypharmacy. It was also reported that apremilast requires less prescreening and monitoring than other conventional and biologic systemic therapies. Overall, apremilast is an attractive option for the individualized treatment of psoriasis owing to its favorable safety profile, its ease of oral administration without the need for screening or ongoing laboratory monitoring, and its positive impact on symptoms and lesions in difficult-to-treat areas.

show abstract

“…109 As other PDE4 inhibitors, APR showed generally an acceptable safety profile. 110 The most common reported AEs were diarrhea, nausea, headache, and URTI. The gastrointestinal side-effects generally occurred within the first month of treatment and subsequently subsided.…”

Section: Targeted Synthetic Dmardsmentioning

confidence: 99%

<p>An Update for the Clinician on Biologics for the Treatment of Psoriatic Arthritis</p>

Chimenti¹,

D’Antonio²,

Conigliaro³

et al. 2020

BTT

Self Cite

View full text Add to dashboard Cite

Psoriatic arthritis (PsA) is a chronic inflammatory arthropathy typically associated with psoriasis (PsO). The pathogenesis is strictly related to the association among the presence of genetic risk alleles and innate and acquired immune response with dramatic consequences on bone remodeling. Clinically, PsA patients may present heterogenicity of articular and periarticular manifestations that may be associated with the presence of comorbidities making treatment decision challenging in patients management. The identification of patient-targeted therapies is still a critical issue. Actually, several biological and synthetic drugs are promising in terms of efficacy and safety profile. National and international treatment recommendations support clinicians in the decision of the best treatment, although they may have limits basically related to updates and different outcomes included in the clinical studies evaluated. The aim of this narrative review is therefore to give guidance for clinicians for PsA patients treatment. For this purpose, we evaluated evidence on biological therapies efficacy used for PsA treatment. Specifically, we reviewed data on biological therapies, Janus kinases (JAK) inhibitors, and drugs with a new mechanism of action that are part of the treatment pipeline. The concept of "switching" and "swapping" is also described, as well as data concerning special populations such as pregnant women and elderly patients.

show abstract

Real life experience of apremilast in psoriasis and arthritis psoriatic patients: Preliminary results on metabolic biomarkers

Cited by 38 publications

References 24 publications

Psoriatic Arthritis and Metabolic Syndrome: Is There a Role for Disease Modifying Anti-Rheumatic Drugs?

Psoriatic Arthritis and Metabolic Syndrome: Is There a Role for Disease Modifying Anti-Rheumatic Drugs?

The Use of Apremilast in Psoriasis: An Indian Perspective on Real-World Scenarios

<p>An Update for the Clinician on Biologics for the Treatment of Psoriatic Arthritis</p>

Contact Info

Product

Resources

About