Apremilast for the treatment of psoriatic arthritis.
Psoriatic arthritis (PsA) is a chronic inflammatory disease of the joints that occurs in patients with psoriasis. The spectrum of PsA includes arthritis, dactylitis, enthesitis, axial involvement, and skin lesions. Non-biologic disease-modifying anti-rheumatic drugs (DMARDs) such as methotrexate and leflunomide, and biologic DMARDs such as tumor necrosis factor (TNF) antagonists and ustekinumab, have been used to treat PsA. Apremilast is a novel therapy that inhibits phosphodiesterase 4, increases intracellular cAMP levels, and modulates expression of inflammatory mediators in favor of anti-inflammatory activity. It decreases the pro-inflammatory cytokines TNF-α, IFN-γ, IL-17, and IL-23 and increases the anti-inflammatory cytokine IL-10 under certain conditions. One phase II and four phase III clinical trials as well as long-term extension studies showed significant and sustained clinical efficacy and an adequate safety profile for apremilast in patients with active psoriatic arthritis.
a Rheumatology Unit, Rheumatology Department , Complejo Hospitalario de Santiago de Compostela , Santiago , Spain.|b IDIS "Ramon Dominguez" , Complejo Hospitalario de Santiago de Compostela , Santiago , Spain.
Alejandro
A
Souto
a Rheumatology Unit, Rheumatology Department , Complejo Hospitalario de Santiago de Compostela , Santiago , Spain.|b IDIS "Ramon Dominguez" , Complejo Hospitalario de Santiago de Compostela , Santiago , Spain.|c Department of Medicine, Medical School , Universidad de Santiago , Santiago de Compostela , Spain.
Juan J
JJ
Gómez-Reino
D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D016207:Cytokines / Q000276:immunology; D006801:Humans; D058988:Phosphodiesterase 4 Inhibitors / Q000627:therapeutic use*; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use
D018501:Antirheumatic Agents; D016207:Cytokines; D058988:Phosphodiesterase 4 Inhibitors; D013792:Thalidomide; C505730:apremilast
Apremilast; phosphodiesterase 4; psoriatic arthritis