Apremilast Pharmacogenomics in Russian Patients with Moderate-to-Severe and Severe Psoriasis

Verbenko, Dmitry А.; Карамова, А. Э.; Artamonova, Olga G.; Deryabin, D. G.; Rakitko, Alexander; Chernitsov, Alexandr; Krasnenko, A. Yu.; Elmuratov, Artem; Solomka, V S; Кубанов, А. А.

doi:10.3390/jpm11010020

Cited by 13 publications

(15 citation statements)

References 75 publications

(46 reference statements)

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“…This has been proved by Verbenko et al, who pointed out the role of genetic polymorphisms as important factors for individual variations in drug response in psoriasis. 29 Moreover, this rate of remission among Indian psoriasis patients as reported by the dermatologists is commensurate with worldwide trials. 30 …”

Section: Positioning Of Apremilast In Psoriasissupporting

confidence: 55%

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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Section: Positioning Of Apremilast In Psoriasissupporting

confidence: 55%

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

Rajagopalan¹,

Dogra²,

Saraswat³

et al. 2021

PTT

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“…This investigation identified four SNPs (rs1143633, C/T; rs20541, G/A; rs2201841, A/G/T; rs1800629, A/G) located within different genes (IL-1β, IL-4, IL-23R, and TNF-α) involved in the inflammatory and immune response (Table 3). In particular, patients with the minor allele showed a better outcome to apremilast administration [51]. It is important to remark that these associations are preliminary results and further studies are terribly necessary.…”

Section: Phosphodiesterase-4 Inhibitormentioning

confidence: 80%

Pharmacogenomics: An Update on Biologics and Small-Molecule Drugs in the Treatment of Psoriasis

Caputo

Strafella

Cosio

et al. 2021

Genes

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Pharmacogenomic studies allowed the reasons behind the different responses to treatments to be understood. Its clinical utility, in fact, is demonstrated by the reduction in adverse drug reaction incidence and the improvement of drug efficacy. Pharmacogenomics is an important tool that is able to improve the drug therapy of different disorders. In particular, this review will highlight the current pharmacogenomics knowledge about biologics and small-molecule treatments for psoriasis. To date, studies performed on genes involved in the metabolism of biological drugs (tumor necrosis factor inhibitors and cytokines inhibitors) and small molecules (apremilast, dimethyl fumarate, and tofacitinib) have provided conflicting results, and further investigations are necessary in order to establish a set of biomarkers to be introduced into clinical practice.

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“…Apremilast persistence was high (14 months in patients with psoriasis; 11 months in patients with psoriatic arthritis) and increased with age [ 39 ]. In Russian studies reporting a pharmacogenomic model [ 40 ] and immunological predictors of response [ 41 ] in 34 patients with moderate-to-severe and severe plaque psoriasis receiving apremilast for 26 weeks, 14 patients (41%) achieved a PASI 75. The authors attribute this response rate to the severe psoriasis, long disease duration, and multiple prior therapies observed in more than half (53%) of the patients.…”

Section: Discussionmentioning

confidence: 99%

Apremilast Use in Severe Psoriasis: Real-World Data from Central and Eastern Europe

et al. 2023

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Introduction The broad and sustained efficacy of apremilast for psoriasis has been demonstrated in randomized and real-world observational studies. Data from Central and Eastern Europe (CEE) are lacking. Moreover, apremilast use in this region is limited by country-specific reimbursement criteria. This is the first study to report data on the real-world use of apremilast in the region. Methods APPRECIATE (NCT02740218) was an observational, retrospective, cross-sectional study assessing psoriasis patients 6 (± 1) months after apremilast treatment initiation. The study aimed to describe the characteristics of patients with psoriasis receiving apremilast, estimate treatment outcomes, including Psoriasis Area Severity Index (PASI), Body Surface Area (BSA), and Dermatology Life Quality Index (DLQI), and assess dermatologists' and patients' perspectives on treatment using questionnaires including the Patient Benefit Index (PBI). Adverse event reports were taken from the medical records. Results Fifty patients (Croatia: 25; Czech Republic: 20; Slovenia: 5) were enrolled. In patients continuing apremilast at 6 (± 1) months, mean (± SD) PASI score was reduced from 16.2 ± 8.7 points at treatment initiation to 3.1 ± 5.2 at 6 (± 1) months; BSA from 11.9% ± 10.3% to 0.8% ± 0.9%; DLQI from 13.7 ± 7.4 points to 1.6 ± 3.2. PASI 75 was reached by 81% of patients. Physicians reported that the overall treatment success fulfilled their expectations in more than two thirds of patients (68%). At least three-quarters of patients reported apremilast had a quite or very high benefit on the needs they identified as being most important. Apremilast was well tolerated; no serious or fatal adverse events were identified. Conclusion Apremilast was effective in reducing skin involvement and improving quality of life in CEE patients having severe disease. Treatment satisfaction among physicians and patients was very high. These data add to the growing body of evidence showing consistent effectiveness of apremilast across the continuum of psoriasis disease severity and manifestations. Trial registration ClinicalTrials.gov identifier, NCT02740218. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-023-02468-3.

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Apremilast Pharmacogenomics in Russian Patients with Moderate-to-Severe and Severe Psoriasis

Cited by 13 publications

References 75 publications

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

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

Pharmacogenomics: An Update on Biologics and Small-Molecule Drugs in the Treatment of Psoriasis

Apremilast Use in Severe Psoriasis: Real-World Data from Central and Eastern Europe

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