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Salvatore D'Angelo, Antonio Carriero, Michele Gilio, Francesco Ursini, Pietro Leccese, Carlo Palazzi
Spondyloarthritis (SpA) are chronic inflammatory diseases with overlapping pathogenic mechanisms and clinical features. Treatment armamentarium against SpA includes non-steroidal anti-inflammatory drugs, glucocorticoids, conventional disease-modifying antirheumatic drugs (DMARDs, including sulfasalazine, methotrexate, leflunomide, cyclosporine), targeted synthetic DMARDs (apremilast) and biological DMARDs (TNF inhibitors, anti-IL 12/23 and anti-IL-17 agents). Areas covered: A narrative review of published literature on safety profile of available SpA treatment options was performed...
March 5, 2018: Expert Opinion on Drug Safety
Danielle R McClanahan, Joseph C English
Nail psoriasis (NP) and nail lichen planus (NLP) can be limiting, stigmatizing and difficult to treat. Dermatologists commonly treat psoriasis and lichen planus but when associated onychodystrophy is present or is an isolated finding, some develop apprehension. The goal of this review is to develop therapeutic ladders to be used as a guide for the management of NP and NLP in everyday clinical practice. Evidence-based therapies for NP are robust and range from topical treatments to conventional systemic therapies (i...
February 27, 2018: American Journal of Clinical Dermatology
Yuri A Blednov, Adriana J Da Costa, Tamara Tarbox, Olga Ponomareva, Robert O Messing, R Adron Harris
BACKGROUND: Phosphodiesterase type 4 (PDE4) inhibitors produce widespread anti-inflammatory effects and reduce ethanol consumption in several rodent models. These drugs are potential treatments for several diseases, including central nervous system disorders, but clinical use is limited by their emetic activity. Apremilast is a selective PDE4 inhibitor with fewer gastrointestinal side effects that is FDA approved for the treatment of psoriasis. METHODS: We measured the acute and chronic effects of apremilast on ethanol consumption in male and female C57BL/6J mice using the continuous and intermittent 24-h two-bottle choice drinking models...
February 22, 2018: Alcoholism, Clinical and Experimental Research
Yuri A Blednov, Adriana J Da Costa, R Adron Harris, Robert O Messing
BACKGROUND: In our companion paper, we reported that the phosphodiesterase type 4 inhibitor apremilast reduced ethanol intake and preference in different drinking models in male and female C57BL/6J mice. In the current study, we measured the effects of apremilast on other behaviors that are correlated with ethanol consumption. METHODS: The effects of apremilast (20 mg/kg) on the following behaviors were studied in male and female C57BL/6J mice: locomotor response to a novel situation; ethanol- or LiCl-induced conditioned taste aversion (CTA) to saccharin; conditioned place preference (CPP) and conditioned place avoidance (CPA) to ethanol; severity of handling-induced convulsions after ethanol administration; ethanol-induced anxiolytic-like behavior in the elevated plus maze; duration of ethanol-induced loss of the righting reflex (LORR); recovery from ethanol-induced motor impairment on the rotarod; and acute functional tolerance (AFT) to ethanol...
February 22, 2018: Alcoholism, Clinical and Experimental Research
Linda Stein Gold, Jerry Bagel, Mark Lebwohl, J Mark Jackson, Rongdean Chen, Joana Goncalves, Eugenia Levi, Kristina Callis Duffin
<p>BACKGROUND: Many patients with moderate plaque psoriasis are undertreated despite broadening treatment options. In the phase IV UNVEIL study, oral apremilast demonstrated efficacy and safety in systemic-naive patients with chronic moderate plaque psoriasis with lower psoriasis-involved body surface area (BSA; 5%-10%) during the 16-week, double-blind, placebo-controlled phase. We describe efficacy and safety of apremilast in this population through week 52 in UNVEIL.</p> <p>METHODS: Patients with moderate plaque psoriasis (BSA 5%-10%; static Physician's Global Assessment [sPGA] score of 3 [moderate]) and naive to systemic therapies for psoriasis were randomized (2:1) to receive apremilast 30 mg twice daily or placebo for 16 weeks...
February 1, 2018: Journal of Drugs in Dermatology: JDD
Thomas Reygaerts, Stéphane Mitrovic, Bruno Fautrel, Laure Gossec
OBJECTIVES: Fatigue is a significant issue in psoriatic arthritis. The objective was to assess the effect of biological disease modifying antirheumatic drugs and apremilast on fatigue in psoriatic arthritis randomised controlled trials and to compare this effect with the effect in the same trials, on pain, through a systematic literature review and meta-analysis. METHODS: A systematic literature review was performed up to January 2017 in PubMed, Embase and Cochrane databases...
February 13, 2018: Joint, Bone, Spine: Revue du Rhumatisme
Anne M Loos, Shanshan Liu, Celia Segel, Daniel A Ollendorf, Steven D Pearson, Jeffrey A Linder
BACKGROUND: The comparative effectiveness of available targeted immunomodulators for moderate-to-severe psoriasis has not been evaluated. OBJECTIVE: To evaluate the comparative effectiveness of targeted immunomodulators for adults with moderate-to-severe plaque psoriasis. METHODS: Systematic literature review of placebo-controlled and head-to-head randomized trials of eight targeted immunomodulators that evaluated clinical benefits or harms...
February 10, 2018: Journal of the American Academy of Dermatology
Fatma Alibaz-Oner, Amr H Sawalha, Haner Direskeneli
PURPOSE OF REVIEW: Current treatment modalities in Behçet's disease will be summarized in light of new studies published within the last 2 years. RECENT FINDINGS: There is an increasing interest in the treatment of refractory mucocutaneous symptoms of Behçet's disease, and results were quite promising with apremilast, anakinra, and ustekinumab. Data from large case series confirmed both the efficacy and safety of tumor necrosis factor-α inhibitors for the treatment of refractory major organ manifestations such as ocular, neurologic, vascular, and gastrointestinal involvement...
February 9, 2018: Current Opinion in Rheumatology
Lucie Pellonnet, Fanny Beltzung, Frédéric Franck, Jacques Rouanet, Michel D'incan
No abstract text is available yet for this article.
February 1, 2018: European Journal of Dermatology: EJD
E Papadavid, N Rompoti, K Theodoropoulos, G Kokkalis, D Rigopoulos
BACKGROUND: Psoriasis is a chronic inflammatory skin disease, which requires long term, safe and effective treatment. Apremilast, a small-molecule PDE4 inhibitor, has been introduced as psoriasis (and psoriatic arthritis) treatment in Europe in 2015. OBJECTIVE: We analysed and report the efficacy and safety of apremilast in the first 51 patients with psoriasis that have undergone treatment with this novel small molecule in our outpatient clinic. METHOD: Our primary endpoint was the evaluation of clinical response to apremilast according to the percentage of PASI reduction (ΔPASI) at 16 weeks after treatment initiation...
February 1, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Arvin Ighani, Jorge R Georgakopoulos, Linda L Zhou, Scott Walsh, Neil Shear, Jensen Yeung
BACKGROUND: Apremilast is a new oral drug for the treatment of moderate to severe plaque psoriasis that reduces inflammation by inhibiting phosphodiesterase 4. Its efficacy and safety data are limited; hence, real-world outcomes are important for elucidating the full spectrum of its adverse events (AEs) and expanding generalizability of clinical trial findings. OBJECTIVE: Assess the efficacy and safety of apremilast monotherapy in real-world practice. METHODS: A retrospective chart review was conducted in 2 academic dermatology practices...
January 1, 2018: Journal of Cutaneous Medicine and Surgery
Evangelia Papadavid, Georgios Kokkalis, Georgios Polyderas, Konstantinos Theodoropoulos, Dimitrios Rigopoulos
Background: Apremilast is a new immunomodulatory drug, a small molecule inhibitor of PDE4, which down-regulates the expression of multiple pro-inflammatory cytokines, such as tumor necrosis factor alpha, interleukin 17, interleukin 23. Main observations: We describe a case of a 54-year-old man with erythroderma in the course of psoriasis (PASI=49), with contraindications to other psoriasis therapies, in whom total clearance of skin lesions was achieved by day 20 after therapy with apremilast at a dose of 30 mg bid (ΔPASI = 100)...
December 1, 2017: Journal of Dermatological Case Reports
Marianne Lerch, Carlo Mainetti, Benedetta Terziroli Beretta-Piccoli, Thomas Harr
Recognition and timely adequate treatment of erythema multiforme remain a major challenge. In this review, current diagnostic guidelines, potential pitfalls, and modern/novel treatment options are summarized with the aim to help clinicians with diagnostic and therapeutic decision-making. The diagnosis of erythema multiforme, that has an acute, self-limiting course, is based on its typical clinical picture of targetoid erythematous lesions with predominant acral localization as well as histological findings...
February 2018: Clinical Reviews in Allergy & Immunology
Antonella Di Cesare, Leonardo Pescitelli, Federica Ricceri, Linda Lazzeri, Francesca Prignano
No abstract text is available yet for this article.
January 19, 2018: International Journal of Dermatology
Jean-Paul J Abboud, Alexander Whittington, Masih Ahmed, Jesse T Himebaugh, Lee A Wiley, Ahmad Haffar, John Nguyen
Ichthyosis is a cutaneous disorder characterized by excessive amounts of dry thickened skin surface scales. Ocular manifestations of ichthyosis include cicatricial ectropion, which may cause exposure keratoconjunctivitis and rarely corneal perforation. Topical emollients, anti-inflammatory ointments, and systemic retinoids have been used to control the disease process, while surgical correction with donor graft has been reserved for severe cases involving corneal exposure. The authors report a case of a Caucasian male with lamellar ichthyosis with severe bilateral upper and lower eyelid cicatricial ectropion and corneal ulceration requiring surgical correction...
January 17, 2018: Ophthalmic Plastic and Reconstructive Surgery
Peter Nash, Kamal Ohson, Jessica Walsh, Nikolay Delev, Dianne Nguyen, Lichen Teng, Juan J Gómez-Reino, Jacob A Aelion
OBJECTIVE: Evaluate apremilast efficacy across various psoriatic arthritis (PsA) manifestations beginning at week 2 in biological-naïve patients with PsA. METHODS: Patients were randomised (1:1) to apremilast 30 mg twice daily or placebo. At week 16, patients whose swollen and tender joint counts had not improved by ≥10% were eligible for early escape. At week 24, all patients received apremilast through week 52. RESULTS: Among 219 randomised patients (apremilast: n=110; placebo: n=109), a significantly greater American College of Rheumatology 20 response at week 16 (primary outcome) was observed with apremilast versus placebo (38...
January 17, 2018: Annals of the Rheumatic Diseases
Laura Sawyer, Iain Fotheringham, Emily Wright, Najeeda Yasmeen, Carl Gibbons, Anders Holmen Møller
PURPOSE: To evaluate the relative efficacy of brodalumab compared with approved biologic therapies and apremilast for moderate-to-severe psoriasis. METHODS: We searched MEDLINE, Embase and Cochrane for randomized controlled trials reporting induction phase responses. The primary analysis examined the proportion of patients achieving Psoriasis Area Severity Index (PASI) 50, 75, 90 or 100 responses using a random-effects Bayesian multinomial likelihood model with probit link, with and without adjustment for variation in study-level placebo responses...
January 11, 2018: Journal of Dermatological Treatment
Christian Kromer, Daniel Celis, Diana Sonntag, Wiebke K Peitsch
Biological therapy for moderate-to-severe psoriasis is highly effective but cost-intensive. This systematic review aimed at analyzing evidence on the cost-effectiveness of biological treatment of moderate-to-severe psoriasis. A literature search was conducted until 30/06/2017 in PubMed, Cochrane Library, LILACS, and EconLit. The quality of identified studies was assessed with the checklist by the Centre for Reviews and Dissemination guidance. Out of 482 records, 53 publications were eligible for inclusion. Half of the studies met between 20 and 25 of the quality checklist items, displaying moderate quality...
2018: PloS One
Annie Langley, Jennifer Beecker
Apremilast is a relatively new therapy for the treatment of moderate to severe plaque psoriasis in adults. While this medication is considered safe with a very low risk of serious side effects, a few common (≥5% of patients) mild to moderate side effects have been reported, including diarrhea, nausea, headache, and nasopharyngitis. Not addressing these symptoms may lead to medication nonadherence and unnecessary discontinuation of therapy. These side effects are often easily managed with interventions available to the practicing dermatologist, and in only rare instances will these side effects require dose adjustment or discontinuation of therapy...
December 1, 2017: Journal of Cutaneous Medicine and Surgery
P Kawalec, P Holko, P Moćko, A Pilc
To assess the comparative effectiveness and safety of novel biologic therapies in psoriatic arthritis (PsA) and to establish the position of the non-anti-tumor necrosis factor α (TNF-α) biologic drugs in the treatment regimen of the disease. A systematic review and network meta-analysis (NMA) was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) requirements. Two investigators identified the studies, abstracted data, and assessed the risk of bias independently...
February 2018: Rheumatology International
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