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Ioannides D, Antonakopoulos N, Chasapi V, Oikonomou C, Tampouratzi E, Lazaridou E, Rigopoulos D, Neofotistou O, Drosos A, Anastasiadis G, Rovithi E, Kalinou C, Papadavid E, Aronis P, Papageorgiou M, Protopapa A, Bassukas I, Lefaki I, Zafiriou E, Krasagakis K, Pokas E, Anagnostopoulos Z, Kekki A, Papakonstantis M. A real-world, non-interventional, prospective study of the effectiveness and safety of apremilast in bio-naïve adults with moderate plaque psoriasis treated in the routine care in Greece - The 'APRAISAL' study. J Eur Acad Dermatol Venereol 2022; 36:2055-2063. [PMID: 35451115 DOI: 10.1111/jdv.18166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/10/2022] [Accepted: 03/25/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Real-world data in patients with moderate psoriasis treated with apremilast is limited. OBJECTIVES To evaluate the effectiveness and safety of apremilast in bio-naïve patients with moderate psoriasis in real-world clinical settings. METHODS This was a 52-week multicenter, observational, prospective study of adult outpatients with moderate psoriasis {[10%<body surface area<20% or 10<psoriasis area severity index (PASI)<20] and 10<dermatology quality of life index (DLQI)<20} initiated on apremilast ≤7 days before enrollment. Missing data were imputed using the last observation carried forward method. RESULTS A total of 287 eligible patients (median age: 54.2 years; median psoriasis duration: 9.8 years) were consecutively enrolled. At baseline, the median DLQI and PASI scores were 12.0 and 11.8, respectively. The 52-week DLQI ≤5 and PASI75 response rates were 68.3% and 61.0%. At 52 weeks, 70.8% and 72.7% of the patients shifted from moderate/severe/very severe to clear/minimal scalp and palmoplantar psoriasis involvement, respectively; the pruritus severity state improved in 67.2%. The 52-week Kaplan-Meier estimated drug continuation rate was 85.3%. The adverse drug reaction rate was 19.9%. CONCLUSIONS Apremilast is a safe and effective treatment for bio-naïve patients with moderate psoriasis and specific psoriasis manifestations.
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Affiliation(s)
- D Ioannides
- 1st University Department of Dermatology, Aristotle University of Thessaloniki, Hospital for Venereal & Skin Diseases of Thessaloniki, Greece
| | | | - V Chasapi
- Dermatology and Venereology Department of N.H.S,"Andreas Sygros" Hospital, Athens, Greece
| | - C Oikonomou
- Department of Dermatology, University General Hospital of Patras, Greece
| | - E Tampouratzi
- Dermatology Unit, Regional General Hospital "Tzaneio,", Piraeus, Greece
| | - E Lazaridou
- 2nd University Department of Dermatology, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital of Thessaloniki, Greece
| | - D Rigopoulos
- 1st Department of Dermatology & Venereology, National Kapodistrian University of Athens, "Andreas Sygros" Hospital, Athens, Greece
| | - O Neofotistou
- Dermatology Department, "Konstantopoulio" District General Hospital of Nea Ionia, Greece
| | - A Drosos
- Department of Dermatology, General Hospital of Xanthi, Greece
| | - G Anastasiadis
- Department of Dermatology, "Evaggelismos" General Hospital of Athens, Greece
| | - E Rovithi
- Department of Dermatology and Venereology, "Venizeleio- Pananeio" General Hospital of Heraklion, Greece
| | - C Kalinou
- Outpatient Department of Dermatology, "Agios Pavlos" General Hospital of Thessaloniki, Greece
| | - E Papadavid
- 2nd Department of Dermatology & Venereology, National Kapodistrian University of Athens, "Attikon" University General Hospital, Athens, Greece
| | - P Aronis
- Clinical Dermatology, Hellenic Airforce 251 General Hospital, Athens, Greece
| | - M Papageorgiou
- State Department of Dermatology, Hospital for Venereal & Skin Diseases of Thessaloniki, Greece
| | - A Protopapa
- Outpatient Department of Dermatology, General Hospital of Sitia, Greece
| | - I Bassukas
- Department of Skin and Venereal Diseases, University of Ioannina, Greece
| | - I Lefaki
- Dermatology Unit, "EUROMEDICA" General Clinic, Thessaloniki, Greece
| | - E Zafiriou
- University Clinic of Dermatology, University General Hospital of Larissa, Greece
| | - K Krasagakis
- Department of Dermatology, University General Hospital of Heraklion, Greece
| | - E Pokas
- Outpatient Department of Dermatology, "KAT" General Hospital of Attica, Athens, Greece
| | | | - A Kekki
- Genesis Pharma, Halandri, Greece
| | - M Papakonstantis
- Clinic of Dermatology, 401 General Military Hospital of Athens, Greece
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Ioannides D, Antonakopoulos N, Georgiou S, Chasapi V, Katsantonis I, Drosos A, Rigopoulos D, Antoniou C, Anastasiadis G, Bassukas I, Ioannidou D, Protopapa A, Neofotistou O, Krasagakis K, Aronis P, Papageorgiou M, Lazaridou E, Patsatsi A, Lefaki I, Roussaki-Schulze AV, Satra F, Anagnostopoulos Z, Papakonstantis M. Effectiveness and safety of apremilast in biologic-naïve patients with moderate psoriasis treated in routine clinical practice in Greece: the APRAISAL study. J Eur Acad Dermatol Venereol 2021; 35:1838-1848. [PMID: 34036627 DOI: 10.1111/jdv.17392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/28/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Apremilast is an oral phosphodiesterase-4 inhibitor indicated for patients with moderate-to-severe chronic plaque psoriasis and active psoriatic arthritis. OBJECTIVES To examine the effectiveness of apremilast on Dermatology Life Quality Index (DLQI), Psoriasis Area and Severity Index (PASI) and nail, scalp and palmoplantar involvement, when administered prior to biologics. METHODS This 52-week real-world study included biologic-naive adults with moderate psoriasis (psoriasis-involved body surface area 10% to <20%, or PASI 10 to <20 and DLQI 10 to <20). Apremilast was initiated ≤7 days before enrolment. Data from the first 100 eligible patients who completed 24 weeks (W24) of observation (or were prematurely withdrawn) are presented in this interim analysis using the last-observation-carried-forward imputation method. RESULTS Eligible patients (mean age: 49.9 years; 71.0% males; median disease duration: 8.0 years) were consecutively enrolled between April and October 2017, by 18 dermatology specialists practising in hospital outpatient settings in Greece. Baseline DLQI (median: 12.0) and PASI (median: 11.7) scores improved (P < 0.001) at all postbaseline timepoints (Weeks 6, 16 and 24; W24 median decreases: 9.0 and 9.4 points respectively). At W24, DLQI ≤5, DLQI 0 or 1, and PASI-75 response rates were 63.0%, 25.0% and 48.0% respectively. The Nail Psoriasis Severity Index score in patients with baseline nail involvement (n = 57) decreased at all postbaseline timepoints (P < 0.001; W24 median decrease: 20.0 points). At W24, 50.0% and 51.7% of patients with baseline scalp (n = 76) and palmoplantar (n = 29) involvement respectively achieved postbaseline Physician's Global Assessment (PGA) score of 0 or 1 if baseline score was ≥3, or 0 if baseline score was 1 or 2. The adverse drug reaction rate was 21.0% (serious: 2.0%). CONCLUSIONS These interim results indicate that through 24 weeks, apremilast improved quality of life and reduced disease severity in biologic-naive patients with moderate plaque psoriasis, while demonstrating safety consistent with the known safety profile.
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Affiliation(s)
- D Ioannides
- 1st University Department of Dermatology, Aristotle University of Thessaloniki, Hospital of Venereal & Skin Diseases of Thessaloniki, Thessaloniki, Greece
| | | | - S Georgiou
- Department of Dermatology, University General Hospital of Patras, Patras, Greece
| | - V Chasapi
- Dermatology and Venereology Department of N.H.S, 'Andreas Sygros' Hospital Athens, Athens, Greece
| | - I Katsantonis
- Dermatology Unit, Piraeus Regional General Hospital 'Tzaneio', Piraeus, Greece
| | - A Drosos
- Department of Dermatology, General Hospital of Xanthi, Xanthi, Greece
| | - D Rigopoulos
- 1st Department of Dermatology & Venereology, National Kapodistrian University of Athens, 'Andreas Sygros' Hospital, Athens, Greece
| | - C Antoniou
- 1st Department of Dermatology & Venereology, National Kapodistrian University of Athens, 'Andreas Sygros' Hospital, Athens, Greece
| | - G Anastasiadis
- Department of Dermatology, General Hospital of Athens 'Evangelismos', Athens, Greece
| | - I Bassukas
- Department of Skin and Venereal Diseases, University of Ioannina, Ioannina, Greece
| | - D Ioannidou
- Department of Dermatology and Venereology, General Hospital of Heraklion 'Venizeleio- Pananeio', Heraklion, Greece
| | - A Protopapa
- Outpatient Department of Dermatology, General Hospital of Sitia, Sitia, Greece
| | - O Neofotistou
- Dermatology Department, Konstantopoulio District General Hospital of Nea Ionia, Athens, Greece
| | - K Krasagakis
- Department of Dermatology, University General Hospital of Heraklion, Heraklion, Greece
| | - P Aronis
- Clinical Dermatology, Hellenic Airforce 251 General Hospital, Athens, Greece
| | - M Papageorgiou
- State Department of Dermatology, Hospital of Venereal & Skin Diseases of Thessaloniki, Thessaloniki, Greece
| | - E Lazaridou
- 2nd University Department of Dermatology, Aristotle University of Thessaloniki, General Hospital of Thessaloniki 'Papageorgiou', Thessaloniki, Greece
| | - A Patsatsi
- 2nd University Department of Dermatology, Aristotle University of Thessaloniki, General Hospital of Thessaloniki 'Papageorgiou', Thessaloniki, Greece
| | - I Lefaki
- Dermatology Unit, 'EUROMEDICA' General Clinic, Thessaloniki, Greece
| | - A V Roussaki-Schulze
- University Clinic of Dermatology, University General Hospital of Larissa, Larissa, Greece
| | - F Satra
- Genesis Pharma, Athens, Greece
| | | | - M Papakonstantis
- Clinic of Dermatology, 401 General Military Hospital of Athens, Athens, Greece
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