EFFICACY OF SELECTIVE PDE-4 INHIBITOR IN PATIENTS WITH PSORIASIS: CLINICAL OBSERVATIONS

Cover Page


Cite item

Full Text

Abstract

Objective: We aim to present preliminary on about the efficacy of a new drug for plaque psoriasis and psoriatic arthritis treatment - an oral selective PDE-4 inhibitor (apremilast) in 3 psoriasis patients and evaluate apremilast efficacy and safety.

Materials and methods: The study enrolled patients with moderate-to-severe plaque psoriasis and psoriatic arthritis who demonstrated lack of efficacy, negative side effects or intolerance to systemic therapy with methotrexate, acitretin, and phototherapy in anamnesis. Patients were administered with apremilast according to the prescription (start 10 mg daily, stepwise increase to 30 mg taken orally twice a day). The severity was estimated by PASI, BSA, sPGA, ptPGA; the patient’s quality of life was determined by DLQI. The efficacy was evaluated at week 14.

Results: All patients reached significant clinical improvement (two patients reached ΔPASI50, one patient ΔPASI75, improvement of the nail plate state).

Conclusion: According to our observations, apremilast is safe and effective for the treatment of moderate-to-severe plaque psoriasis, scalp and nail psoriasis, and psoriatic arthritis.

About the authors

A. A. Kubanov

State Research Center of Dermatovenereology and Cosmetology

Email: alex@cnikvi.ru
ORCID iD: 0000-0002-7625-0503

Alexey A. Kubanov - MD, PhD, Professor.

Moscow, SPIN-код: 8771-4990

Россия

A. Е. Karamova

State Research Center of Dermatovenereology and Cosmetology

Author for correspondence.
Email: karamova@cnikvi.ru
ORCID iD: 0000-0003-3805-8489

Arfenya E. Karamova - MD, PhD.

Moscow, SPIN-код: 3604-6491 Россия

O. G. Artamonova

State Research Center of Dermatovenereology and Cosmetology

Email: artamonova_olga@list.ru
ORCID iD: 0000-0003-3778-4745

Olga G. Artamonova - PG student.

Moscow, SPIN-код: 3308-3330

Россия

References

  1. Федеральные клинические рекомендации. Дерматовенерология 2015: Болезни кожи. Инфекции, передаваемые половым путем / Под ред. Кубановой А.А. — М.: Деловой экспресс; 2016. — 768 с.
  2. who.int [Internet]. World Health Organisation: Global report on psoriasis, 2016 [cited 2018 Feb 27]. Available from: http://apps.who.int/iris/bitstream/10665/204417/1/9789241565189_eng.pdf.
  3. Danielsen K, Olsen AO, Wilsgaard T, Furberg AS. Is the prevalence of psoriasis increasing? A 30-year follow-up of a population-based cohort. Br J Dermatol. 2013;168(6):1303–1310. doi: 10.1111/bjd.12230.
  4. Lynde CW, Poulin Y, Vender R, et al. Interleukin 17A: toward a new understanding of psoriasis pathogenesis. J Am Acad Dermatol. 2014;71(1):141–150. doi: 10.1016/j.jaad.2013.12.036.
  5. Kim J, Krueger JG. The immunopathogenesis of psoriasis. Dermatol Clin. 2015;33(1):13–23. doi: 10.1016/j.det.2014.09.002.
  6. Li K, Armstrong AW. A review of health outcomes in patients with psoriasis. Dermatol Clin. 2012;30(1):61–72. doi: 10.1016/j.det.2011.08.012.
  7. Ревматология. Российские клинические рекомендации / Под ред. Насонова Е.Л. — М.: ГЭОТАР-Медиа; 2017. — 464 с.
  8. Peterson G, Silfast-Kaiser A, Menter A. Systemic therapies in psoriasis. In: Yamauchi PS, editor. Biologic and systemic agents in dermatology. Cham, Switzerland: Springer International Publishing; 2018. pp. 145–158. doi: 10.1007/978-3-319-66884-0_16.
  9. Foulkes AC, Warren RB. Pharmacogenomics and the resulting impact on psoriasis therapies. Dermatol Clin. 2015;33(1):149–160. doi: 10.1016/j.det.2014.09.011.
  10. Naldi L, Griffiths CE. Traditional therapies in the management of moderate to severe chronic plaque psoriasis: an assessment of the benefits and risks. Br J Dermatol. 2005;152(4):597–615. doi: 10.1111/j.1365-2133.2005.06563.x.
  11. Kelly JB 3rd, Foley P, Strober BE. Current and future oral systemic therapies for psoriasis. Dermatol Clin. 2015;33(1):91–109. doi: 10.1016/j.det.2014.09.008.
  12. Abuabara K, Wan J, Troxel AB, et al. Variation in dermatologist beliefs about the safety and effectiveness of treatments for moderate to severe psoriasis. J Am Acad Dermatol. 2013;68(2):262–269. doi: 10.1016/j.jaad.2012.07.007
  13. Hsu L, Armstrong AW. Anti-drug antibodies in psoriasis: a critical evaluation of clinical significance and impact on treatment response. Expert Rev Clin Immunol. 2013;9(10):949–958. doi: 10.1586/1744666X.2013.836060.
  14. Wcisło-Dziadecka D, Zbiciak-Nylec M, Brzezińska-Wcisło L, et al. Newer treatments of psoriasis regarding IL-23 inhibitors, phosphodiesterase 4 inhibitors, and Janus kinase inhibitors. Dermatol Ther. 2017;30(6):e12555. doi: 10.1111/dth.12555.
  15. Schafer PH, Truzzi F, Parton A, et al. Phosphodiesterase 4 in inflammatory diseases: Effects of apremilast in psoriatic blood and in dermal myofibroblasts through the PDE4/CD271 complex. Cell Signal. 2016;28(7):753–763. doi: 10.1016/j.cellsig.2016.01.007.
  16. Jimenez JL, Punzon C, Navarro J, et al. Phosphodiesterase 4 inhibitors prevent cytokine secretion by T lymphocytes by inhibiting nuclear factor-kappaB and nuclear factor of activated T cells activation. J Pharmacol Exp Ther. 2001;299(2):753–759.
  17. Schafer PH, Parton A, Gandhi AK, et al. Apremilast, a cAMP phosphodiesterase-4 inhibitor, demonstrates anti-inflammatory activity in vitro and in a model of psoriasis. Br J Pharmacol. 2010;159(4):842–855. doi: 10.1111/j.1476-5381.2009.00559.x.
  18. Schett G, Sloan VS, Stevens RM, Schafer P. Apremilast: a novel PDE4 inhibitor in the treatment of autoimmune and inflammatory diseases. Ther Adv Musculoskelet Dis. 2010;2(5):271–278. doi: 10.1177/1759720X10381432.
  19. Vujic I, Herman R, Sanlorenzo M, et al. 014 Apremilast in psoriasis — a prospective real-world study. J Invest Dermatol. 2017;137(10):S195. doi: 10.1016/j.jid.2017.07.110.
  20. Papp K, Reich K, Leonardi CL, et al. Apremilast, an oral phosphodiesterase 4 (PDE4) inhibitor, in patients with moderate to severe plaque psoriasis: results of a phase III, randomized, controlled trial (Efficacy and Safety Trial Evaluating the Effects of Apremilast in Psoriasis [ESTEEM] 1). J Am Acad Dermatol. 2015;73(1):37–49. doi: 10.1016/j.jaad.2015.03.049.
  21. Nast A, Gisondi P, Ormerod AD, et al. European S3-Guidelines on the systemic treatment of psoriasis vulgaris - Update 2015 - Short version - EDF in cooperation with EADV and IPC. J Eur Acad Dermatol Venereol. 2015;29(12):2277–2294. doi: 10.1111/jdv.13354.

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2018 "Paediatrician" Publishers LLC



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies