PracticeUpdate Conference Series World Congress of Dermatology 2019

Real-WorldDataDemonstrate Apremilast Reduces Psoriasis Disease Severity Even those with hard-to-treat manifestations experienced relief. A premilast offered patients with moderate-to-severe plaque pso- riasis improvements in disease (DLQI) score was 13.4, which indicated a very large impact on quality of life.

At follow-up 5 to 7 months after apremi- last initiation, 72.3% of patients continued apremilast therapy. Patients continuing therapy had a PASI of 4.4 and an affected body surface area of 8.4%. Clinical improvement was observed among 75.4% of patients with pruritus, 72.0% of patients with scalp involvement, 67.6% of patients with nail involvement, and 76.1% of patients with palmoplantar involvement. The mean improvement in DLQI score for patients continuing therapy was 7.1. For those that discontinued apremilast therapy, 13.5% did so due to lack of efficacy, 11.7% due to safety/tolerability reasons, and 2.5% for other reasons not specified. The most common adverse events observed were diarrhea (18.8%), nausea (14.4%) and headache (8.8%). The “reported adverse events were consistent with the known safety profile of apremi- last,” reported Dr. Augustin. The APPRECIATE study “adds to the body of evidence demonstrating that apremilast is an effective treatment option for a proportion of patients with moderate-to-severe psoriasis, with nota- ble improvements in quality of life and disease severity for the overall population and in patients with specific manifesta- tions of psoriasis,” he continued. “In patients with limited skin symptoms but who are affected by pruritus and/or scalp, nail, and palmoplantar involvement, conventional systemic treatments may not be effective in alleviating their disease burden,” he added. “Given the difficulty in treating these areas, the data from APPRECIATE illustrate the potential of apremilast in treating these manifestations. “Patients with more moderate skin involve- ment and who suffer from additional manifestations also have a poor quality of life, and all this should be taken into account when considering individual patient treat- ment options,” Dr. Augustin advised. Apremilast is approved in 20 coun- tries for the treatment of psoriasis. The APPRECIATE study was supported by Celgene, manufacturers of apremilast.

severity and quality of life in a real-world setting, according to the results of the APPRECIATE real-world evidence study. For the APPRECIATE study, a multinational, retrospective, cross-sectional study of psoriasis patients treated with apremilast in clinical practice, investigators enrolled 480 psoriasis patients with a mean dis- ease duration of 18.6 years and mean age of 51.3 years from 87 sites in Austria, Germany, Ireland, Sweden, Switzerland, and the United Kingdom. Patients were eligible if they had chronic plaque psoria- sis and could be contacted 5 to 7 months after apremilast initiation.

" In a complex, multifaceted disease such as psoriasis, real-world data is increasingly important in fully understanding the place and value of medicines. "

“The study was designed to capture the clinical experience with apremilast, as documented and described by clinicians and patients in a real-world setting,” study presenter Matthias Augustin, MD, of the University Medical Center Hamburg in Germany told Elsevier’s PracticeUpdate . “In a complex, multifaceted disease such as psoriasis, real-world data is increas- ingly important in fully understanding the place and value of medicines. “To this end,” he continued, “the APPRECIATE study, reflecting the use of apremilast across a variety of countries in clinical practice, provides important insights, particularly in patients with more moderate skin involvement but other spe- cific disease manifestations.” At treatment initiation, 67.7% of patients had pruritus, 67.7% had scalp involvement, 37.9% had nail involvement, and 23.8% had palmoplantar involvement. The mean Psoriasis Area and Severity Index (PASI) score was 12.5, whereas the affected body surface area was 25.4%. The mean baseline Dermatology Life Quality Index

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PRACTICEUPDATE CONFERENCE SERIES • WCD 2019 16