Yazici H
Professor of Medicine (Rheumatology), Academic Hospital, Istanbul, Turkey.
Drugs Today (Barc). 2020 May;56(5):303-310. doi: 10.1358/dot.2020.56.5.3147942.
Apremilast, an oral small molecule, is a phosphodiesterase 4 (PDE-4) blocker. It has been shown to be efficacious in managing psoriasis (PS) and psoriatic arthritis (PSA). In two controlled studies, it was also effective in controlling oral ulcers of Behçet syndrome (Bsy). The main side effects associated with apremilast are diarrhea, nausea and headaches. These are usually transient and apremilast requires almost no laboratory monitoring during its use. An important issue is whether apremilast will also be useful in other debilitating and life-threatening manifestations of Bsy, for which there is yet no negative or positive evidence. The experience with apremilast use in PS/PSA will surely be helpful in foreseeing and managing potential adverse events of apremilast use for any other indication in Bsy. On the other hand, the author does not consider the proposed similarities in disease mechanisms between PS/PSA and Bsy strong enough to guide us as to where and when to use apremilast in Bsy.
阿普司特是一种口服小分子药物，是一种磷酸二酯酶4（PDE - 4）抑制剂。已证明它在治疗银屑病（PS）和银屑病关节炎（PSA）方面有效。在两项对照研究中，它在控制白塞病（Bsy）的口腔溃疡方面也有效果。与阿普司特相关的主要副作用是腹泻、恶心和头痛。这些通常是短暂的，并且在使用阿普司特期间几乎不需要实验室监测。一个重要问题是阿普司特在白塞病的其他使人衰弱和危及生命的表现中是否也有用，对此尚无负面或正面证据。在银屑病/银屑病关节炎中使用阿普司特的经验肯定有助于预见和管理在白塞病中使用阿普司特用于任何其他适应症时可能出现的不良事件。另一方面，作者认为银屑病/银屑病关节炎与白塞病之间所提出的疾病机制相似性不足以指导我们在白塞病中何时何地使用阿普司特。
