The risk of treated anxiety and treated depression among patients with psoriasis and psoriatic arthritis treated with apremilast compared to biologics, DMARDs and corticosteroids: a cohort study in the United States MarketScan database

Vasilakis‐Scaramozza, Catherine; Persson, Rebecca; Hagberg, Katrina Wilcox; Jick, Susan S.

doi:10.1111/jdv.16231

Cited by 13 publications

(14 citation statements)

References 12 publications

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“…On the other hand, short-term clinical trials reported a somewhat elevated risk of depression in apremilast users, resulting in a label warning. However, long-term data and real-world evidence suggest that users of apremilast had similar rates of depression compared with users of other systemic non-corticosteroid PsA drugs [ 118 , 119 ]. Similar considerations can be made for suicide.…”

Section: Resultsmentioning

confidence: 99%

Management of particular clinical situations in psoriatic arthritis: an expert’s recommendation document based on systematic literature review and extended Delphi process

et al. 2021

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To establish practical recommendations for the management of patients with psoriatic arthritis (PsA) with particular clinical situations that might lead to doubts in the pharmacological decision-making. A group of six expert rheumatologists on PsA identified particular clinical situations in PsA. Then, a systematic literature review (SLR) was performed to analyse the efficacy and safety of csDMARDs, b/tsDMARDs in PsA. In a nominal group meeting, the results of the SLR were discussed and a set of recommendations were proposed for a Delphi process. A total of 65 rheumatologists were invited to participate in the Delphi. Agreement was defined if ≥ 70% of the participants voted ≥ 7 (from 1, totally disagree to 10, totally agree). For each recommendation, the level of evidence and grade of recommendation was established based on the Oxford Evidence-Based Medicine categorisation. Particular clinical situations included monoarthritis, axial disease, or non-musculoskeletal manifestations. The SLR finally comprised 131 articles. A total of 16 recommendations were generated, all but 1 reached consensus. According to them, it is crucial to carefully analyse the impact of individual manifestations on patients (disability, quality of life, etc.), but also to recognise the impact of each drug singularities on selected clinical phenotypes to adopt the most appropriate treatment strategy. Early diagnosis and treatment to target approach, along with a close risk management, is also necessary. These recommendations are intended to complement gaps in national and international guidelines by helping health professionals address and manage particular clinical situations in PsA.

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Section: Resultsmentioning

confidence: 99%

Management of particular clinical situations in psoriatic arthritis: an expert’s recommendation document based on systematic literature review and extended Delphi process

et al. 2021

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“… 35 , 46 , 47 However, little is known about whether systemic treatment for psoriasis is associated with an increased risk of anxiety and depression, and whether these risks differ between the various treatments. 48 …”

Section: Use Of Apremilast For Plaque Psoriasis In Special Populationsmentioning

confidence: 99%

“…The results of short-term clinical trials and post-marketing cases suggested that apremilast was associated with an elevated risk of depression, anxiety, and suicidal thoughts, to a certain extent. 48 According to post-marketing data, out of 105,000 patients who received apremilast, only 65 patients reported either depression and/or suicidal thoughts or behavior, of whom 32 patients improved after discontinuation of therapy. 49 Based on these reports, precaution is recommended when prescribing apremilast in patients with a history of depression and/or suicidal thoughts or behavior, as per prescribing information.…”

Section: Use Of Apremilast For Plaque Psoriasis In Special Populationsmentioning

confidence: 99%

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

Rajagopalan¹,

Dogra²,

Saraswat³

et al. 2021

PTT

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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.

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“…Recently, there has been also a growing interest in drugs used by psoriasis patients and their effects on the psychiatric disorders that accompany psoriasis Molecules 2022, 27, 1412 2 of 19 patients. While systemic corticosteroids have been associated with a high risk of depression and anxiety in psoriasis patients, biologics have been demonstrated to have the potential to reduce the risk of depression than conventional treatments such as methotrexate, cyclosporine, and systemic corticosteroids [15][16][17][18][19]. This increased the need to develop alternative medicines for psoriasis treatments to ameliorate the inflammatory skin symptoms and psychological comorbidities in the patients.…”

Section: Introductionmentioning

confidence: 99%

Coptisine Alleviates Imiquimod-Induced Psoriasis-like Skin Lesions and Anxiety-like Behavior in Mice

et al. 2022

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Psoriasis is a common inflammatory skin disorder, which can be associated with psychological disorders, such as anxiety and depression. This study investigated the efficacy and the mechanism of action of a natural compound coptisine using imiquimod (IMQ)-induced psoriasis mice. Coptisine reduced the severity of psoriasis-like skin lesions, decreased epidermal hyperplasia and the levels of inflammatory cytokines TNF-α, IL-17, and IL-22. Furthermore, coptisine improved IMQ-induced anxiety in mice by increasing the number of entries and time in open arms in the elevated plus maze (EPM) test. Coptisine also lowered the levels of inflammatory cytokines TNF-α and IL-1β in the prefrontal cortex of psoriasis mice. HaCaT keratinocytes and BV2 microglial cells were used to investigate the effects of coptisine in vitro. In M5-treated HaCaT cells, coptisine decreased the production of IL-6, MIP-3α/CCL20, IP-10/CXCL10, and ICAM-1 and suppressed the NF-κB signaling pathway. In LPS-stimulated BV2 cells, coptisine reduced the secretion of TNF-α and IL-1β. These findings suggest that coptisine might be a potential candidate for psoriasis treatment by improving both disease severity and psychological comorbidities.

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The risk of treated anxiety and treated depression among patients with psoriasis and psoriatic arthritis treated with apremilast compared to biologics, DMARDs and corticosteroids: a cohort study in the United States MarketScan database

Cited by 13 publications

References 12 publications

Management of particular clinical situations in psoriatic arthritis: an expert’s recommendation document based on systematic literature review and extended Delphi process

Management of particular clinical situations in psoriatic arthritis: an expert’s recommendation document based on systematic literature review and extended Delphi process

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

Coptisine Alleviates Imiquimod-Induced Psoriasis-like Skin Lesions and Anxiety-like Behavior in Mice

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