Safety and efficacy of apremilast through 104 weeks in patients with moderate to severe psoriasis who continued on apremilast or switched from etanercept treatment: findings from the LIBERATE study

Reich, Kristian; Gooderham, Melinda; Bewley, Anthony; Green, L; Soung, Jennifer; Petric, Rosemary; Marcsisin, J; Cirulli, Joshua; Chen, R; Piguet, Vincent

doi:10.1111/jdv.14738

Cited by 54 publications

(51 citation statements)

References 7 publications

(27 reference statements)

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“…Hence, the respective efficacies of apremilast and methotrexate in truly treatment‐naive patients with psoriasis have not been assessed. Moreover, there is much less evidence of the long‐term clinical effectiveness and safety of apremilast in this setting, except for open‐label extension studies including selected populations of patients with psoriasis …”

mentioning

confidence: 99%

Persistence of apremilast in moderate‐to‐severe psoriasis: a real‐world analysis of 14 147 apremilast‐ and methotrexate‐naive patients in the French National Health Insurance database

et al. 2019

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Summary Background Real‐world data on the persistence of apremilast vs. methotrexate are inconclusive. Objectives To assess and compare the long‐term persistence of apremilast and methotrexate in a large cohort of patients with psoriasis. Methods All adult patients with psoriasis registered in the French national health insurance database (‘Système National des Données de Santé’) between 2009 and 2017 were eligible for inclusion. The study population comprised apremilast‐ and methotrexate‐naive patients, defined as those with a first prescription of apremilast or methotrexate. Levels of persistence were compared using a Cox model with propensity‐score matching that included potential confounders (notably age, sex, psoriatic arthritis, comorbidities and previous exposure to topical and systemic treatments). Results In this nationwide population‐based cohort, 14 147 adult patients with psoriasis (mean age 52·3 years, 55·2% male) were found to be naive to both apremilast and methotrexate. After propensity‐score matching, two subgroups of 4805 patients with similar baseline characteristics were included, of whom 3207 apremilast‐treated patients and 2736 methotrexate‐treated patients discontinued their treatment. Kaplan–Meier survival propensity‐score analyses revealed a discontinuation rate of 69% for apremilast and 59% for methotrexate in the first year of treatment. Apremilast‐treated patients had a higher risk of discontinuation than methotrexate‐treated patients when considering the study population as a whole (hazard ratio 1·28, 95% confidence interval 1·23–1·34) or in a propensity‐score‐matched analysis (hazard ratio 1·34, 95% confidence interval 1·27–1·41; P < 0·001). Conclusions Our real‐world data suggest that in the first year of treatment, the discontinuation rate was significantly higher for apremilast‐treated patients than for methotrexate‐treated patients, regardless of the previous therapeutic lines received. What's already known about this topic? Psoriasis is a common chronic, relapse–remitting, inflammatory skin disease associated with severe psychosocial impact. Apremilast, a phosphodiesterase 4 inhibitor, is one of the most recently commercialized psoriasis drugs. Little is known about the long‐term clinical effectiveness of apremilast. What does this study add? The discontinuation rate at 1 year for apremilast was 69%, compared with 58% for methotrexate, in a nationwide population‐based cohort including 14 147 nonselected adult patients with psoriasis. Patients in the apremilast cohort had a higher risk of discontinuation than patients in the methotrexate cohort using propensity‐score matching, including potentially relevant individual risk factors such as age, sex, comorbidities and psoriatic arthritis, and regardless of the previous therapeutic lines received. In daily practice, physicians should take these results into account when choosing between methotrexate and apremilast as a first‐line systemic therapy.

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mentioning

confidence: 99%

Persistence of apremilast in moderate‐to‐severe psoriasis: a real‐world analysis of 14 147 apremilast‐ and methotrexate‐naive patients in the French National Health Insurance database

et al. 2019

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“…Skin, scalp, and nail involvement was assessed. NAPSI change from baseline was −48.1 to −51.1% [14].…”

Section: Apremilastmentioning

confidence: 90%

Small Molecules and Biologics in the Treatment of Nail Psoriasis

Rigopoulos

Stathopoulou

Gregoriou³

2020

Skin Appendage Disord

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Nail psoriasis (PsO) is a disorder with profound impact on patients’ quality of life. Several challenges and unmet needs remain in the treatment of nail PsO. Introduction of biologics and small molecules in the treatment of nail PsO has allowed for rapid control of the disease and high efficacy. The aim of this review was to present the published studies on nail PsO therapy with biologics and small molecules and illuminate the results in the studies where the design and outcome evaluation had nail PsO in the forefront.

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“…Apremilast is now being used to successfully treat psoriasis [9][10][11] and psoriatic arthritis [12], atopic dermatitis [13], lichen planus, Behçet disease [14], ankylosing spondylitis [15], discoid lupus [16], chronic cutaneous sarcoidosis [17] and other inflammatory dermatoses.…”

Section: Apremilastmentioning

confidence: 99%

Paths for Improving Bevacizumab Available in 2018: The ADZT Regimen for Better Glioblastoma Treatment

Kast¹

2018

Preprint

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During glioblastoma treatment, the pharmaceutical monoclonal antibody to VEGF, bevacizumab, has improved quality of life and delayed progression for several months but has not, or only marginally prolonged overall survival. In 2017 several dramatic research papers appeared that are crucial to our understanding of glioblastoma vis a vis the mode of action of bevacizumab. As a consequence of these papers, a new, potentially more effective, treatment protocol can be built around bevacizumab. This is the ADZT Regimen where four old drugs are added to bevacizumab. These four are apremilast, marketed to treat psoriasis, dapsone, marketed to treat Hansen’s disease, zonisamide, marketed to treat seizures, and telmisartan, marketed to treat hypertension. The ancillary attributes of each of these drugs has been shown to augment bevacizumab. This paper will detail the research data supporting that contention.

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Safety and efficacy of apremilast through 104 weeks in patients with moderate to severe psoriasis who continued on apremilast or switched from etanercept treatment: findings from the LIBERATE study

Cited by 54 publications

References 7 publications

Persistence of apremilast in moderate‐to‐severe psoriasis: a real‐world analysis of 14 147 apremilast‐ and methotrexate‐naive patients in the French National Health Insurance database

Persistence of apremilast in moderate‐to‐severe psoriasis: a real‐world analysis of 14 147 apremilast‐ and methotrexate‐naive patients in the French National Health Insurance database

Small Molecules and Biologics in the Treatment of Nail Psoriasis

Paths for Improving Bevacizumab Available in 2018: The ADZT Regimen for Better Glioblastoma Treatment

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