Retrospective study of apremilast drug survival in psoriasis patients in a daily practice setting: A long‐term experience

Abstract

There is limited evidence about the real‐world survival of apremilast in patients with psoriasis, especially over the long term. To evaluate the long‐term survival of apremilast and its predictive factors when used to treat psoriasis. A retrospective hospital‐based study, including data collected from 104 patients. Survival curves were estimated using the Kaplan–Meier estimator. Proportional hazard Cox regression models were used for multivariate analysis. The average duration of the treatment before discontinuation was 28.82 months (95% CI, 22.08–35.57 months) and the median was 12 months (95% CI, 2.68–21.31 months). The retention rates were 51% (1 year), and 33% (5 years). The survival study revealed statistically significant differences between patients with PASI<10 and those in the PASI≥10 group (log‐rank test, p < 0.001). The 5‐year prevalences were 64% for patients with a PASI of <10 and 5% for those with an index ≥10. In the PASI < 10‐patient group, the retention rates were 77% (1 year) and 64% (5 years). Furthermore, 66% of patients who continued apremilast treatment for more than 2 years were receiving off‐label doses (30 mg/day). Apremilast may be a suitable and efficient alternative for the treatment of psoriasis patients in the PASI<10 group.

Four‐year drug survival of apremilast in patients with psoriasis

“…In clinical trials of apremilast, during the long‐term follow‐ups (≥156 weeks) the drug was discontinued in 34.7% of patients owing to lack of efficacy in the study, and in 11.2% of patients it was discontinued owing to adverse events 4 . In real‐world studies that examined the use of apremilast, 1‐year survival rates have been reported to be approximately 30%–50% 5–7 . Moreover, we also reported drug survival for apremilast in 2019, with a 1‐year drug survival rate of 53.4% 8 .…”

“…The 4-year survival rate in our study was 30%, roughly similar to previous reports, with approximately 20% at 4 years, 5 28.1% at 4 years, 6 and 33% at 5 years. 7 Of 23 patients who discontinued apremilast due to hospital transfer, 13 continued apremilast at their family physicians, therefore the actual continuation rate may have been a little higher. Approximately 49% of patients had one or more adverse events, which was similar to that in real-world data 9,10 and less than that in clinical trials.…”

“…5-7 Moreover, we also reported drug survival for apremilast in 2019, with a 1-year drug survival rate of 53.4%. 8 To the best of our knowledge, only a few reports have examined drug survival for more than 4 years, [5][6][7] therefore in the present study, we extended the study period to examine the long-term drug survival rate of apremilast, the reasons for discontinuation, and the frequency of adverse events.…”