Real-world apremilast use in biologic-naïve psoriatic arthritis patients. Data from Spanish clinical practice

Apremilast is approved for treatment of psoriasis and psoriatic arthritis (PsA). Real-world evidence on apremilast effectiveness in clinical practice is limited. Observational study enrolling adult patients, across 21 Spanish centres, who had initiated apremilast in the prior 6 (±1) months and were...

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Published in:Reumatología clinica 2024-01, Vol.20 (1), p.24-31
Main Authors: Gratacós-Masmitja, Jordi, Beltrán, Emma, Vega, José Luis Alvarez, Urruticoechea-Arana, Ana, Fito, Concepción, Maceiras, Francisco, Otano, Joaquín María Belzunegui, Melón, Julia Fernández, Carmona, Eugenio Chamizo, Hernández, Miguel Ángel Abad, Vilamajó, Inmaculada Ros, Oreiro, Sonia Castro, Alfonso, Eva Pascual, Alonso, Juan Carlos Torre
Format: Article
Language:English
Subjects:
Apremilast
Artritis psoriásica
Biologic naïve
Biológico naïve
Estudio observacional
Evidencia real
Observational study
Persistence
Persistencia
Psoriatic arthritis
Real-world evidence
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Summary:Apremilast is approved for treatment of psoriasis and psoriatic arthritis (PsA). Real-world evidence on apremilast effectiveness in clinical practice is limited. Observational study enrolling adult patients, across 21 Spanish centres, who had initiated apremilast in the prior 6 (±1) months and were biologic naive. Data were collected at routine follow-up visits 6 and 12 months after apremilast initiation. Primary outcome was 6 and 12-month persistence to apremilast. Secondary outcomes included Disease Activity for PsA (DAPSA), joint erosions, enthesitis, dactylitis, and patient-reported quality of life (QoL, measured using the PsA impact of disease [PsAID] questionnaire). We included 59 patients. Most had oligoarticular PsA, moderate disease activity, and high comorbidity burden. Three-quarters were continuing apremilast at 6 months and two-thirds at 12 months; mean (SD) apremilast treatment duration was 9.43 (1.75) months. DAPSA scores showed improved disease activity: one-third of patients in remission or low activity at apremilast initiation versus 62% and 78% at 6 and 12 months, respectively. Eleven of 46 patients with radiographic assessments had joint erosions at apremilast initiation and none at month 12. Median (Q1, Q3) number of swollen joints was 4.0 (2.0, 6.0) at apremilast initiation versus 0.0 (0.0, 2.0) at 12 months. Incidence of dactylitis and enthesitis decreased between apremilast initiation (35.6% and 28.8%, respectively) and month 12 (11.6% and 2.4%, respectively). Over two-thirds of patients had a PSAID-9 score
ISSN:1699-258X
2173-5743
DOI:10.1016/j.reuma.2023.06.007