EFFICACY AND SAFETY OF APREMILAST IN MODERATE TO SEVERE CASES OF CHRONIC PLAQUE PSORIASIS: A RETROSPECTIVE STUDY

S KHAN; M FAROOQ; F TARIQ; R AHMED; MA ASLAM

doi:10.54112/bcsrj.v2023i1.180

Authors

S KHAN Department of Dermatology, Bahria University Medical and Dental College Karachi, Pakistan
M FAROOQ Department of Dermatology, Bakhtawar Amin Trust Hospital Multan, Pakistan
F TARIQ Department of Medicine, Sahiwal Teaching Hospital Sahiwal, Pakistan
R AHMED Department of Biochemistry, Independent Medical College Faisalabad, Pakistan
MA ASLAM Department of Statistical Analysis, Bahauddin Zakariya University (BZU) BZU Multan, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.180

Keywords:

Plaque psoriasis, skin disease, apremilast

Abstract

The objective of this study was to assess the efficacy and safety of Apremilast in patients with moderate-to-severe plaque psoriasis. A retrospective study was conducted in the Dermatology Department of Bakhtawar Amin Trust Hospital Multan from September 2021 to September 2022. A total of 102 patients were included in the study after evaluation. Apremilast was administered in all the patients, and its clinical response was assessed by the extent of Psoriasis Area Severity Index (PASI) reduction 16 weeks after the start of treatment. Our secondary endpoints included examining the PASI; Dermatology Life Quality Index (DLQI); Physician Global Assessment (PGA); the adverse effects of treatment; survival rate; reasons for discontinuation of treatment, if any, and the rate of patients who managed to reach Psoriasis Area Severity Index reduction up to 50%, 75%, 90% and 100% after 16 weeks. 37 (72.5%) subjects achieved PASI reduction ≥75% or ≥50%, thus achieving the primary endpoint. The majority of the study sample had moderate psoriasis, with a mean baseline DLQI score of 11.2, PASI score of 11.0 and PGA score 2.6. After 16 weeks, 65% subjects had PGA score ≤1. PASI improved rapidly over 4 (4.8) (P<.001) to 16 weeks (4.3) (P<.001). DLQI at baseline was 11.2; after 16 weeks, it was 3.8 (P<.001). Regarding secondary endpoints, after 16 weeks, 35/37 (94.5%) subjects achieved ΔPASI≥50, 18/37 (48.6%) ΔPASI≥75, 8/37 (21.6%) achieved ΔPASI≥90 and 6/37(16.2%) achieved ΔPASI100. Treatment-related adverse effects occurred in 16/51 (31.3%) patients. In total, treatment was stopped in 6 (11.6%)subjects because of adverse effects; gastrointestinal disorders were the most common. Apremilast is an effective and safe drug for the treatment of patients with moderate-to-severe plaque psoriasis.

Downloads

Download data is not yet available.

References

Barbieri, J. S., Beidas, R. S., Gondo, G. C., Fishman, J., Williams, N. J., Armstrong, A. W., Ogdie, A. R., Mehta, N., and Gelfand, J. M. (2022). Analysis of specialist and patient perspectives on strategies to improve cardiovascular disease prevention among persons with psoriatic disease. JAMA dermatology 158, 252-259.

Crowley, J., Thaçi, D., Joly, P., Peris, K., Papp, K. A., Goncalves, J., Day, R. M., Chen, R., Shah, K., and Ferrándiz, C. (2017). Long-term safety and tolerability of apremilast in patients with psoriasis: Pooled safety analysis for≥ 156 weeks from 2 phase 3, randomized, controlled trials (ESTEEM 1 and 2). Journal of the American Academy of Dermatology 77, 310-317. e1.

Liu, Y., Li, Y., and Du, H. (2022). Efficacy of apremilast for psoriasis: a meta-analysis of randomized controlled studies. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii 39.

Mayba, J. N., and Gooderham, M. J. (2017). Real-world experience with apremilast in treating psoriasis. Journal of cutaneous medicine and surgery 21, 145-151.

Metyas, S., Tomassian, C., Messiah, R., Gettas, T., Chen, C., and Quismorio, A. (2019). Combination therapy of apremilast and biologic agent as a safe option of psoriatic arthritis and psoriasis. Current Rheumatology Reviews 15, 234-237.

Muddasani, S., Fleischer, A. B., and Feldman, S. R. (2021). Treatment practices for psoriasis and how they are changing. Journal of the American Academy of Dermatology 84, 579-581.

Nijakowski, K., Gruszczyński, D., Kolasińska, J., Kopała, D., and Surdacka, A. (2022). Periodontal Disease in Patients with Psoriasis: A Systematic Review. International Journal of Environmental Research and Public Health 19, 11302.

Ogdie, A., Coates, L. C., and Gladman, D. D. (2020). Treatment guidelines in psoriatic arthritis. Rheumatology 59, i37-i46.

Papadavid, E., Katsimbri, P., Kapniari, I., Koumaki, D., Karamparpa, A., Dalamaga, M., Tzannis, K., Βoumpas, D., and Rigopoulos, D. (2016). Prevalence of psoriatic arthritis and its correlates among patients with psoriasis in Greece: results from a large retrospective study. Journal of the European Academy of Dermatology and Venereology 30, 1749-1752.

Rajagopalan, M., Dogra, S., Saraswat, A., Varma, S., and Banodkar, P. (2021). the use of apremilast in psoriasis: an Indian perspective on real-world scenarios. Psoriasis: Targets and Therapy 11, 109.

Reich, K., Bomas, S., Korge, B., Manasterski, M., Schwitchtenberg, U., Mentz, H., and Groegel, K. (2017). First" Real-World" Insights on Apremilast Treatment for Patients with Plaque Psoriasis from the LAPIS-PSO Study: An Interim Analysis. SKIN The Journal of Cutaneous Medicine 1, s15-s15.

Rendon, A., and Schäkel, K. (2019). Psoriasis pathogenesis and treatment. International journal of molecular sciences 20, 1475.

Tampouratzi, E., Papakonstantis, M., Katsantonis, J., Sidiropoulos, T., Delli, F., Efthymiadis, K., Sfaelos, K., Christodoulou, A., Chasapi, V., and Panagakis, P. (2022). Clinical evidence on the use of brodalumab for the treatment of psoriasis in Greece: Experience from clinical practice of four tertiary hospitals. Dermatologic Therapy, e15532.

Vujic, I., Herman, R., Sanlorenzo, M., Posch, C., Monshi, B., Rappersberger, K., and Richter, L. (2018). Apremilast in psoriasis–a prospective real‐world study. Journal of the European Academy of Dermatology and Venereology 32, 254-259.

Wollenberg, A., Kinberger, M., Arents, B., Aszodi, N., Avila Valle, G., Barbarot, S., Bieber, T., Brough, H., Calzavara Pinton, P., and Christen‐Zäch, S. (2022). European guideline (EuroGuiDerm) on atopic eczema–part II: non‐systemic treatments and treatment recommendations for special AE patient populations. Journal of the European Academy of Dermatology and Venereology 36, 1904-1926.

Young, M., and Roebuck, H. L. (2016). Apremilast, an oral phosphodiesterase 4 (PDE4) inhibitor: A novel treatment option for nurse practitioners treating patients with psoriatic disease. Journal of the American Association of Nurse Practitioners 28, 683-695. https://doi.org/10.1111/jdv.14598