阿普斯特片治疗银屑病效果怎样

Apremilast tablets are effective in treating psoriasis and are well tolerated. Apremilast reduces skin flaking and scaling by reducing the activity in the immune system that causes chronic inflammation and plaque formation. Apremilast is a novel, oral, small-molecule phosphodiesterase 4 (PDE4) inhibitor that works by dose-dependently inhibiting the release of tumor necrosis factor (TNF)-alpha from human synoviocytes.

Experimental efficacy of tablets in treating psoriasis

One trial evaluated the long-term efficacy and safety of apremilast in the treatment of moderate to severe plaque psoriasis and the safety of switching from etanercept to apremilast in a phase 3b liberation trial.

Methods: 250 patients were randomly divided into placebo, apremilast 30 mg BID, or etanercept 50 mg QW until week 16; thereafter, all patients continued or switched to apremilast at week 104 (extension period). Patient-reported outcomes (PROs) were assessed using the Psoriasis Area and Severity Index (PASI; 0-72), Scalp Physicians Global Assessment (ScPGA; 0-5), and Nail Psoriasis Severity Index; and using the Dermatology Life Quality Index (DLQI; 0-32) and Pruritus Visual Analogue Scale (VAS; 0-100 mm).

Results: The Apremilast extension phase (weeks 16-104) included 226 patients in the placebo/apremilast (n=73), apremilast/apremilast (n=74), and etanercept/apremilast (n=79) arms, of whom 50.7%, 45.9%, and 51.9%, respectively, had a ≥75% decrease in PASI score from baseline at week 104 (based on last observation carried forward analysis).

Across treatment groups, 50.0%-59.2% of patients achieved ScPGA 0 (clear) or 1 (minimal); the mean change in NAPSI from baseline ranged from -48.1% to -51.1%; 66.0%-72.5% of patients had a DLQI score ≤5; the mean change in pruritus VAS ranged from -24.4 to -32.3. AEs (adverse events) did not increase with prolonged apremilast exposure in ≥5% of patients.

Conclusions: Apremilast demonstrated significant and sustained improvements in skin, scalp, nails, and PROs (itch and quality of life) in patients with moderate to severe plaque psoriasis over 104 weeks. Safety is consistent with the known safety profile of Apremilast.

Common side effects of Apremilast include diarrhea, nausea, headache, upper respiratory tract infection, etc. Overall, the safety profile is relatively tolerable. It should be noted that it is contraindicated in patients with known allergies to the prodrugs or any excipients in the formulation. It is recommended that patients take medication as directed by their doctor and receive symptomatic treatment.

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References

Reich K, Gooderham M, Bewley A, Green L, Soung J, Petric R, Marcsisin J, Cirulli J, Chen R, Piguet V. Safety and efficacy of apremilast through 104 weeks in patients with moderate to severe psoriasis who continued on apremilast or switched from etanercept treatment: findings from the LIBERATE study. J Eur Acad Dermatol Venereol. 2018 Mar;32(3):397-402. doi: 10.1111/jdv.14738. Epub 2018 Jan 29. PMID: 29220542; PMCID: PMC5873268.