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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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Katsimpri P, Vassilopoulos D, Katsifis G, Vosvotekas G, Bogdanos D, Sidiropoulos P, Vounotrypidis P, Georgountzos A, Bounas A, Garyfallos A, Gazi S, Georgiou P, Kataxaki E, Papagoras C, Elezoglou A, Liossis SN, Tzioufas A, Voulgari P, Satra Tzoufra F, Anagnostopoulos Z, Antonakopoulos N, Sfikakis P. AB0537 PSORIATIC ARTHRITIS BURDEN, QUALITY OF LIFE AND FUNCTIONAL ABILITY IMPAIRMENTS IN PATIENTS INITIATED ON APREMILAST IN THE ROUTINE CARE IN GREECE: INTERIM RESULTS FROM THE MULTICENTER PROSPECTIVE STUDY “APROACH”. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with substantial psychosocial burden and health-related quality of life (HRQoL) and functional ability impairments.Objectives:To characterize the profile of patients with PsA initiating therapy with apremilast in routine care settings, in terms of the physician-assessed clinical disease burden and the patient-reported generic and disease-related HRQoL and functional disability.Methods:This is an ongoing 52-week multicenter, prospective study conducted in the Greek healthcare environment. Eligible patients are bio-naïve adults with active peripheral PsA, inadequate (within the first 12 months of treatment) response/intolerance to a prior conventional synthetic disease-modifying antirheumatic drug (csDMARD), and no prior use of tofacitinib, initiating apremilast as per the approved label. Data are being collected by physician assessments, as performed in routine clinical practice, and by patient-reported outcomes. 170 patients enrolled in the study; data at apremilast initiation (baseline) from the first 100 eligible consenting patients are presented in this interim analysis as per protocol.Results:99 evaluable patients were consecutively enrolled in 19 rheumatology departments between 15-Apr-2019 and 13-Jan-2020. At baseline (Table 1) [mean (SD) age: 53.8 (11.7) years], 43.4% of the patients had at least one (30.3% had ≥2) ongoing comorbidity other than PsA/PSO. The median [interquartile range (IQR)] PsA and psoriasis duration were 1.9 (1.0-3.5) and 7.5 (3.9-16.8) years, respectively. All subjects were on csDMARD while 24.2% received combination therapy, oral non-steroid anti-inflammatory drugs (32.3%), topical treatments (20.2%) and systemic steroids (11.1%). Based on the Clinical Disease Activity in PsA (cDAPSA) score, 58.6% of the patients had moderate, and 29.3% high disease activity. In the EuroQol (EQ) 5-Dimensions (5D) 5-Levels questionnaire, 93.9, 82.8, 82.8, 73.7, and 51.5% of the patients reported problems in ‘pain/discomfort’, ‘anxiety/depression’, ‘usual activities’, ‘mobility’, and ‘self-care’, respectively. The median (IQR) baseline UK-weighted EQ-5D index and EQ-Visual Analogue Scale scores were 0.55 (0.44-0.70) and 50.0 (40.0-70.0), respectively. The median (IQR) Health Assessment Questionnaire-Disability Index (HAQ-DI) and mean (SD) PsA Impact of Disease 12-item (PsAID12) scores were 1.0 (0.5-1.4) and 4.6 (2.0), respectively.Conclusion:More than 8 out of 10 bio-naïve patients initiated on apremilast in the routine clinical care in Greece have at least moderate disease activity, active psoriasis, and problems with pain/discomfort, anxiety/depression, and performance of usual activities at a median of 2 years post-diagnosis. HAQ-DI and PsAID12 scores indicate moderate impairment of physical functionality and PsA-related HRQoL. The findings underscore considerable disease burden early in the disease course.Table 1.Baseline characteristicsN%/Mean/MedianWomen, %57/9957.6Peripheral joint involvement only, %92/9992.9Polyarthritis (≥5 joints), %69/9969.7cDAPSA (range: 0-154), median (IQR)9922.0 (16.0-29.0)Number of SJC (0-66) / TJC (0-68), median (IQR)994 (2-8) / 6 (2-10)Active psoriasis (BSA>0%), %83/9983.8BSA score, median (IQR)77/835.0 (2.0-12.0)Nail involvement, %38/9639.6Enthesitis and/or dactylitis, %30/9531.6Dactylitis, %11/9511.6Finger and toe Dactylitis Severity Score (DSS) (range: 0-60), median (IQR)10/112.0 (1.0-6.0)Enthesitis, %22/9523.2 LEI score (range: 0-14), median (IQR)222.0 (1.0-2.0)Extra-articular manifestations (mainly fatigue), %10/9910.1Comorbidities in ≥15% of the patientsHypertension, Essential hypertension, %23/9923.2Dyslipidemia, hypercholesterolemia, (type V) hyperlipidemia, %15/9915.2Total PsAID12 score (range: 0-10), mean (SD)984.6 (2.0)Total HAQ-DI score (range: 0-3), median (IQR)991.0 (0.5-1.4)Disclosure of Interests:PELAGIA KATSIMPRI Speakers bureau: Janssen, Genesis pharma, Novartis, Abbvie, UCB, Hospital Line, Actelion Pharmaceuticals, Pfizer, Consultant of: Janssen, Genesis pharma, Novartis, Abbvie, UCB, Hospital Line, Actelion Pharmaceuticals, Pfizer, Dimitrios Vassilopoulos Speakers bureau: AbbVie, Janssen, MSD, Novartis, Pfizer, Roche, UCB, Grant/research support from: AbbVie, GenesisPharma, Νovartis, Pfizer, Roche, UCB, Janssen, MSD, Gkikas Katsifis Speakers bureau: Abbvie, Aenorasis, Amgen, Genesis Pharma, Bausch Health, BMS, Celgene, Janssen, MSD, Novartis, Roche, Pfizer, UCB, Grant/research support from: Abbvie, Aenorasis, Amgen, Genesis Pharma, Bausch Health, BMS, Celgene, Janssen, MSD, Novartis, Roche, Pfizer, UCB, GEORGIOS VOSVOTEKAS Speakers bureau: MSD, Consultant of: AbbVie, Novartis, Dimitrios Bogdanos Speakers bureau: Menarini, Novartis, Consultant of: Fresenius Kabi Hellas, Novartis, Grant/research support from: Aenorasis, Elpen, Genesis Pharma, GlaxoSmithKline, Boehringer Ingelheim, Lilly, Prodromos Sidiropoulos Grant/research support from: University of Crete Special Account for Research and pharma, Periklis Vounotrypidis Speakers bureau: Genesis Pharma, MSD, Novartis, Grant/research support from: Genesis Pharma, MSD, Novartis, Athanasios Georgountzos Grant/research support from: AbbVie, Genesis Pharma, Janssen, Mylan SAS, Pfizer, Roche, UCB, Andreas Bounas: None declared., Alexandros Garyfallos Speakers bureau: AbbVie, BGP, Roche, Consultant of: Genesis Pharma, UCB, Pfizer, Sousana Gazi: None declared., Panagiotis Georgiou Grant/research support from: Janssen-Cilag, Novartis, UCB, Evaggelia Kataxaki Speakers bureau: Novartis, Charalampos Papagoras Speakers bureau: Abbvie, Novartis, Genesis, Lilly, Biogen, Aenorasis, GSK, Pfizer, ANTONIA ELEZOGLOU: None declared., Stamatis-Nick Liossis: None declared., Athanasios Tzioufas Grant/research support from: AbbVie, Genesis Pharma, GSK, Horizon, Lilly, Novartis, Pfizer, Paraskevi Voulgari Speakers bureau: GlaxoSmithKline, Novartis, UCB, Consultant of: GlaxoSmithKline, Novartis, UCB, FOTEINI SATRA TZOUFRA Employee of: GENESIS PHARMA S.A., ZAFEIRIOS ANAGNOSTOPOULOS Employee of: GENESIS PHARMA S.A., NIKOLAOS ANTONAKOPOULOS Employee of: GENESIS PHARMA S.A., Petros Sfikakis Speakers bureau: AbbVie, Boehringer Ingelheim, GenesisPharma, Novartis, Pfizer, UCB, Consultant of: AbbVie, Boehringer Ingelheim, GenesisPharma, Novartis, Pfizer, UCB, Grant/research support from: AbbVie, Boehringer Ingelheim, GenesisPharma, Novartis, Pfizer, UCB.
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