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Real-World Effectiveness and Safety of Apremilast in Older Patients with Psoriasis

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Abstract

Introduction

Apremilast is a drug recently developed for psoriasis. Few data are available on its use in the elderly. We evaluated the tolerance and effectiveness of apremilast used in daily practice for psoriasis treatment in older patients.

Methods

We performed a multicenter, retrospective study involving patients aged ≥ 65 years who had received apremilast as a psoriasis treatment. Demographic data and details regarding psoriasis and adverse events (AEs) were collected from patient medical records.

Results

135 patients were included (mean age: 73.5 years). Treatment was stopped in 74 patients (54.8%) for AEs (n = 43, 56.6%), primary failures (n = 18, 23.4%), and relapses (n = 7, 9.2%). When patients were stratified by age at treatment initiation, the main cause of discontinuation in patients ≥ 75 years was AEs, whereas in patients aged 65–74 years it was primary failures (28.3%). Sixty-one patients reported AEs, mainly digestive (n = 49). Regarding effectiveness, 45.2% of patients reached PGA 0/1 between 3 and 6 months after treatment initiation. One-year apremilast continuation rates were better in the 65–74 and 75–84 years subgroups than in the > 85 years subgroup (p = 0.01).

Conclusion

Apremilast seems to be an effective and safe therapeutic option for psoriasis in the elderly. The main AEs reported by patients did not seem to differ from those reported previously in younger populations. However, AEs were more frequent in patients > 75 years old leading to more frequent discontinuation of apremilast compared with younger patients, suggesting a higher level of vigilance is needed in the elderly.

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Acknowledgements

GEM Resopso collaborators: Jean-Luc Perrot, Mireille Ruer-Mulard, Caroline Jacobzone, Nathalie Quiles-Tsimaratos, Vincent Descamps, Maud Steff, Paul Bilan, Annie Vermersch-Langlin, Mathilde Kemula, Emmanuelle Amazan, Ingrid Kupfer-Bessaguet, Anne-Caroline Cottencin, Bulai Livideanu, Jeremy Gottlieb.

Author information

Authors and Affiliations

  1. Service de Dermatologie, Hôpital Victor Dupouy, 69 rue du Lieutenant-Colonel Prud’hon, 95100, Argenteuil, France

    Céline Phan & Emmanuel Mahé

  2. Service de Dermatologie, Centre Hospitalier du Mans, Le Mans, France

    Nathalie Beneton

  3. Service de Dermatologie, CHU Angers, Angers, France

    Juliette Delaunay

  4. Service de Dermatologie, Polyclinique Courlancy, Reims, France

    Ziad Reguiai & Mahtab Samimi

  5. Service de Dermatologie, Hôpital Jacques Monod, Le Havre, France

    Claire Boulard

  6. Service de Dermatologie, Hôpital d’Instruction des Armées Begin, Saint Mandé, France

    Anne-Claire Fougerousse

  7. Dermatology Department, Dipartimento di Scienze Mediche, Chirurgiche e Neuroscienze, A.O.U.S. Le Scotte, Universitàdegli Studi di Siena, Siena, Italy

    Elisa Cinotti

  8. Dermatology Department, Università de Pisa, Pisa, Italy

    Marco Romanelli

  9. Service de Dermatologie, Centre Hospitalier Intercommunal de Poissy/Saint-Germain-en-Laye, Saint-Germain-en-Laye, France

    Laure Mery-Bossard & Domitille Thomas-Beaulieu

  10. Private Office, La Varenne, France

    Josiane Parier & François Maccari

  11. Service de Dermatologie, Hôpital Sud, Avenue Laënnec, 80054, Amiens Cedex 1, France

    Guillaume Chaby

  12. Private Office, 5 Joinville le Pont, France

    Marie Bastien

  13. Service de Dermatologie, Hôpital de Pontoise, Pontoise, France

    Edouard Begon

  14. Service de Dermatologie, Centre Hospitalier Universitaire de Tours, Tours, France

    Céline Phan, Nathalie Beneton, Juliette Delaunay, Ziad Reguiai, Claire Boulard, Anne-Claire Fougerousse, Elisa Cinotti, Marco Romanelli, Laure Mery-Bossard, Domitille Thomas-Beaulieu, Josiane Parier, François Maccari, Guillaume Chaby, Marie Bastien, Edouard Begon, Mahtab Samimi, Francesca Prignano, Alain Beauchet & Emmanuel Mahé

  15. Dermatology Department, Florence, Italy

    Francesca Prignano

  16. Département de Santé Publique, Centre Hospitalier Universitaire Ambroise Paré, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France

    Alain Beauchet

Authors
  1. Céline Phan
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  2. Nathalie Beneton
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  3. Juliette Delaunay
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  4. Ziad Reguiai
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  5. Claire Boulard
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  6. Anne-Claire Fougerousse
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  7. Elisa Cinotti
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  8. Marco Romanelli
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  9. Laure Mery-Bossard
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  10. Domitille Thomas-Beaulieu
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  11. Josiane Parier
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  12. François Maccari
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  13. Guillaume Chaby
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  14. Marie Bastien
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  15. Edouard Begon
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  16. Mahtab Samimi
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  17. Francesca Prignano
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  18. Alain Beauchet
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  19. Emmanuel Mahé
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Consortia

for the GEM Resopso

  • Jean-Luc Perrot
  • , Mireille Ruer-Mulard
  • , Caroline Jacobzone
  • , Nathalie Quiles-Tsimaratos
  • , Vincent Descamps
  • , Maud Steff
  • , Paul Bilan
  • , Annie Vermersch-Langlin
  • , Mathilde Kemula
  • , Emmanuelle Amazan
  • , Ingrid Kupfer-Bessaguet
  • , Anne-Caroline Cottencin
  • , Bulai Livideanu
  •  & Jeremy Gottlieb

Corresponding author

Correspondence to Céline Phan.

Ethics declarations

Funding

None.

Conflict of interest

Other authors declare no conflicts of interest concerning this article.

Ethical approval

N. Beneton has paid activities as a consultant, advisor, or speaker for Abbvie, Celgene, Leo Pharma, Lilly, Janssen Cilag, Novartis, Pfizer, and UCB; J. Delaunay for Abbvie, Leo Pharma, Novartis, and Janssen Cilag; Z. Reguiai for Celgene, Janssen Cilag, Pfizer, Abbvie, Leo Pharma, Lilly, UCB, Medac, MSD, and Novartis; C. Boulard for Novartis, Abbvie, and Celgene; A.-C. Fougerousse for Novartis, Abbvie, Pfizer, Lilly, Celgene, and Janssen Cilag; L. Méry-Brossard for Abbvie, Leo Pharma, Novartis, Celgene, and Janssen Cilag; D. Thomas-Beaulieu for Novartis, Abbvie, Janssen Cilag, Lilly, Leo Pharma and Celgene; J. Parier for Janssen Cilag, Novartis, Celgene, and Leo Pharma; E. Mahé for Abbvie, Amgen, Janssen Cilag, Celgene, Leo Pharma, Lilly, Novartis, and Pfizer.

Additional information

The members of the GEM Resopso are detailed in the Acknowledgments section.

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Phan, C., Beneton, N., Delaunay, J. et al. Real-World Effectiveness and Safety of Apremilast in Older Patients with Psoriasis. Drugs Aging 37, 657–663 (2020). https://doi.org/10.1007/s40266-020-00781-y

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  • DOI: https://doi.org/10.1007/s40266-020-00781-y

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