E Del Alcázar1, J A Suárez-Pérez2, S Armesto3, R Rivera4, E Herrera-Acosta2, P Herranz5, I Martín6, E Montesinos7, M Hospital8, E Vilarrasa9, M Ferran10, R Ruiz-Villaverde11, A Sahuquillo-Torralba12, D P Ruiz-Genao13, S Pérez-Barrio14, C Muñoz15, M Llamas16, F Valentí17, M J Mitxelena18, A López-Ferrer9, G Carretero19, D Vidal20, J Mollet21, I Belinchón22, J M Carrascosa1. 1. Department of Dermatology, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain. 2. Department of Dermatology, Hospital Universitario Virgen de la Victoria, Málaga, Spain. 3. Department of Dermatology, Hospital Universitario de Valdecilla, Santander, Spain. 4. Department of Dermatology, Hospital Universitario 12 de Octubre, Madrid, Spain. 5. Department of Dermatology, Hospital Universitario La Paz, Madrid, Spain. 6. Department of Dermatology, Hospital Universitario Getafe, Madrid, Spain. 7. Department of Dermatology, Hospital Clínico Universitario de Valencia, Valencia, Spain. 8. Department of Dermatology, Hospital Universitario Puerta de Hierro Majadahonda Madrid, Spain. 9. Department of Dermatology, Hospital Hospital de la Santa Creu I Sant Pau, Barcelona, Spain. 10. Department of Dermatology, Hospital del Mar-Institut Mar d'Investigacions Mèdiques, Barcelona, Spain. 11. Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain. 12. Department of Dermatology, Hospital Universitario y Politécnico La Fe - Instituto de Investigación Sanitaria La Fe, Valencia, Spain. 13. Department of Dermatology, Hospital Universitario Fundación Alcorcón, Madrid, Spain. 14. Department of Dermatology, Hospital Universitario Basurto, Bilbao, Spain. 15. Department of Dermatology, Hospital de Granollers, Granollers, Spain. 16. Department of Dermatology, Hospital Universitario La Princesa, Madrid, Spain. 17. Department of Dermatology, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain. 18. Department of Dermatology, Hospital Universitario de Navarra, Pamplona, Spain. 19. Department of Dermatology, Hospital Universitario Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain. 20. Department of Dermatology, Hospital Moisès Broggi, Sant Joan Despí, Spain. 21. Department of Dermatology, Hospital Universitari Vall d'Hebrón, Barcelona, Spain. 22. Department of Dermatology, Hospital Universitario de Alicante -ISABIAL, UMH Alicante, Alicante, Spain.
Abstract
BACKGROUND: Little has been published on the real-world effectiveness and safety of apremilast in psoriasis. OBJECTIVES: To evaluate the effectiveness, safety and drug survival of apremilast at 52 weeks in patients with moderate to severe plaque psoriasis or palmoplantar psoriasis in routine clinical practice. METHODS: Retrospective, multicentre study of adult patients with moderate to severe plaque psoriasis or palmoplantar psoriasis treated with apremilast from March 2016 to March 2018. RESULTS: We studied 292 patients with plaque psoriasis and 85 patients with palmoplantar psoriasis. The mean (SD) Psoriasis Area and Severity Index (PASI) score was 10.7 (7.0) at baseline and 3.0 (4.2) at 52 weeks. After 12 months of treatment, 73.6% of patients had a PASI score of 3 or less. In terms of relative improvement by week 52, 49.7% of patients achieved PASI-75 (≥75% reduction in PASI score) and 26.5% achieved PASI-90. The mean physician global assessment score for palmoplantar psoriasis fell from 4.2 (5.2) at baseline to 1.3 (1.3) at week 52. Overall drug survival after 1 year of treatment with apremilast was 54.9 %. The main reasons for treatment discontinuation were loss of efficacy (23.9%) and adverse events (15.9%). Almost half of the patients in our series (47%) experienced at least one adverse event. The most common events were gastrointestinal problems. CONCLUSIONS: Apremilast may be a suitable alternative for the treatment of moderate to severe psoriasis and palmoplantar psoriasis. Although the drug has a good safety profile, adverse gastrointestinal effects are common.
BACKGROUND: Little has been published on the real-world effectiveness and safety of apremilast in psoriasis. OBJECTIVES: To evaluate the effectiveness, safety and drug survival of apremilast at 52 weeks in patients with moderate to severe plaque psoriasis or palmoplantar psoriasis in routine clinical practice. METHODS: Retrospective, multicentre study of adult patients with moderate to severe plaque psoriasis or palmoplantar psoriasis treated with apremilast from March 2016 to March 2018. RESULTS: We studied 292 patients with plaque psoriasis and 85 patients with palmoplantar psoriasis. The mean (SD) Psoriasis Area and Severity Index (PASI) score was 10.7 (7.0) at baseline and 3.0 (4.2) at 52 weeks. After 12 months of treatment, 73.6% of patients had a PASI score of 3 or less. In terms of relative improvement by week 52, 49.7% of patients achieved PASI-75 (≥75% reduction in PASI score) and 26.5% achieved PASI-90. The mean physician global assessment score for palmoplantar psoriasis fell from 4.2 (5.2) at baseline to 1.3 (1.3) at week 52. Overall drug survival after 1 year of treatment with apremilast was 54.9 %. The main reasons for treatment discontinuation were loss of efficacy (23.9%) and adverse events (15.9%). Almost half of the patients in our series (47%) experienced at least one adverse event. The most common events were gastrointestinal problems. CONCLUSIONS: Apremilast may be a suitable alternative for the treatment of moderate to severe psoriasis and palmoplantar psoriasis. Although the drug has a good safety profile, adverse gastrointestinal effects are common.
Authors: Thomas Graier; Wolfgang Weger; Paul-Gunther Sator; Wolfgang Salmhofer; Barbara Gruber; Constanze Jonak; Claudia Kölli; Martina Schütz-Bergmayr; Igor Vujic; Gudrun Ratzinger; Nina Häring; Clemens Painsi; Knut Prillinger; Alexander Mlynek; Hans Skvara; Hannes Trattner; Adrian Tanew; Roland Lichem; Christina Ellersdorfer; Franz Legat; Alexandra Gruber-Wackernagel; Angelika Hofer; Erich Schmiedberger; Wolfram Hoetzenecker; Robert Müllegger; Werner Saxinger; Franz Quehenberger; Peter Wolf Journal: JAAD Int Date: 2020-12-26