Department of Dermatology, Jichi Medical University, Tochigi, Japan.
J Dermatol. 2023 Jul;50(7):960-963. doi: 10.1111/1346-8138.16766. Epub 2023 Mar 20.
This real-world study at a single academic center retrospectively examined the drug survival of apremilast for patients with psoriasis. Retrospective information was extracted from the medical records of patients with psoriasis treated with apremilast at the Department of Dermatology, Jichi Medical University Hospital, between March 1, 2017, and June 31, 2021. In total, 281 patients were included in this study. Of these patients, 22% had psoriatic arthritis and 57% had a history of prior systemic treatment, including biologics, before the initiation of apremilast. The 1-, 2-, 3-, and 4-year drug survival rates were 54%, 41%, 32%, and 30%, respectively. Cox regression analysis revealed that sex, duration of plaque psoriasis (<10 years vs ≥10 years), presence of psoriatic arthritis, involvement of scalp lesions, involvement of palmoplantar lesion, involvement of nail lesions, having cardiometabolic comorbidities, and a history of prior systemic treatment did not have any significant impact on drug survival. The most common reason for apremilast discontinuation was inadequate efficacy (27%), followed by adverse events (12%). Approximately 49% of the patients experienced one or more adverse events. Diarrhea was the most common adverse event (24%), followed by nausea (19%) and headache (11%).
这项在单家学术中心开展的真实世界研究回顾性地考察了阿普米司特治疗银屑病患者的药物存续情况。回顾性信息从 2017 年 3 月 1 日至 2021 年 6 月 31 日期间在日本顺天堂大学医学部皮肤科接受阿普米司特治疗的银屑病患者的病历中提取。本研究共纳入 281 例患者。其中，22%的患者患有银屑病关节炎，57%的患者在开始接受阿普米司特治疗前有既往系统治疗（包括生物制剂）史。1、2、3、4 年的药物存续率分别为 54%、41%、32%和 30%。Cox 回归分析显示，性别、斑块状银屑病病程（<10 年与≥10 年）、是否合并银屑病关节炎、头皮受累、掌跖部受累、甲受累、合并心血管代谢合并症以及既往系统治疗史对药物存续均无显著影响。阿普米司特停药的最常见原因是疗效欠佳（27%），其次是不良事件（12%）。约 49%的患者出现 1 种或多种不良事件。腹泻是最常见的不良事件（24%），其次是恶心（19%）和头痛（11%）。
