Saruwatari Dermatology Clinic, Kagoshima, Japan.
J Dermatol. 2019 Dec;46(12):1166-1169. doi: 10.1111/1346-8138.15104. Epub 2019 Oct 6.
Psoriasis, though not an immediately life-threatening disorder, still lowers quality of life and disrupts daily functions. While many treatments for psoriasis exist, few are convenient and safe long term; even if sufficiently effective, treatments themselves often decrease quality of life and make long-term treatment adherence difficult. Approved in Japan in December 2016, apremilast was expected to function as a simple, long-term, systemic therapeutic agent for psoriasis. We report on the clinical outcomes of administrating apremilast for 2 years as observed in 46 psoriatic patients at the Saruwatari Dermatology Clinic between March 2017 and February 2019. We believe the ease of clinic consultation (as compared with large general hospital consultation) draws patients who are busy or have mild symptoms, and consequently poor adherence to regular visits and treatment, reflecting realistic conditions. Major adverse events with apremilast treatment were diarrhea (37.0%) and nausea (15.3%), with most cases of diarrhea being mild. Drug survival analysis by the Kaplan-Meier method revealed a 1-year continuation rate of 46.8% and a 2-year continuation rate of 37.4%. Dermatology Life Quality Index (DLQI) scores during the observation period declined from 9.3 to 2.8 (P < 0.0001) on average, with the DLQI-0/1 achievement rate being 28.6%. Based on our findings, we conclude that apremilast is suitable as a long-lasting basic treatment that is easy to prescribe in small clinics and easy to use in everyday life.
银屑病虽然不会立即危及生命，但仍会降低生活质量并扰乱日常功能。虽然有许多治疗银屑病的方法，但很少有既方便又安全的长期治疗方法；即使治疗方法足够有效，它们本身也常常降低生活质量，使长期治疗的依从性变得困难。阿普米司特于 2016 年 12 月在日本获得批准，有望成为一种治疗银屑病的简单、长期、系统的治疗药物。我们报告了在 2017 年 3 月至 2019 年 2 月期间，在 Saruwatari 皮肤科诊所接受阿普米司特治疗的 46 例银屑病患者的 2 年临床结果。我们认为，与大型综合医院就诊相比，诊所就诊的便利性吸引了那些忙碌或症状较轻的患者，这些患者的治疗依从性较差，难以定期就诊和治疗，这反映了实际情况。阿普米司特治疗的主要不良事件是腹泻（37.0%）和恶心（15.3%），大多数腹泻为轻度。Kaplan-Meier 法药物生存分析显示，1 年的持续率为 46.8%，2 年的持续率为 37.4%。在观察期间，皮肤病生活质量指数（DLQI）评分从 9.3 平均降至 2.8（P<0.0001），DLQI-0/1 达标率为 28.6%。根据我们的发现，我们得出结论，阿普米司特适合作为一种长期基本治疗药物，在小型诊所易于开具，在日常生活中易于使用。
