| Description |
Apremilast (Otezla) was approved by the FDA on March 21, 2014 for the treatment of adult patients with active psoriatic arthritis. Apremilast is a member of a new class of oral small molecule inhibitors of the phosphosphodiesterase 4 (PDE4) enzyme. When PDE4 is inhibited in immune cells, it results in elevation of intracellular cyclic adenosine monophosphate (cAMP) levels, which can regulate inflammatory mediators. The current clinical data indicate that apremilast is an effective and well tolerated option for the management of psoriasis and PsA in adults. |
| Uses |
Treating active psoriatic arthritis. It is also used to treat moderate to severe plaque psoriasis in certain patients. |
| Metabolism and Drug interaction |
Oral administration of apremilast has an absolute biovailability of 73% with peak concentration at 2.5 hours (Tmax). The half-life of apremilast is 6-9 hours. Apremilast is metabolized by the both cytochrome (CYP) and non-CYP pathways. In vitro studies have demonstrated that apremilast metabolism is primarily mediated by the CYP3A4 pathway. Thus, concomitant use of apremilast with CYP450 enzyme inducers (such as rifampin, phenobarbital, carbamazepine, phenytoin) is not recommended. There are no significant drug-drug interactions with oral contraceptives, ketoconazole, or methotrexate. |
| safety information |
1.Apremilast may cause depression. The risk may be greater in patients who have a history of depression or suicidal thoughts or actions. Families and caregivers must closely watch patients who take apremilast. It is important to keep in close contact with the patient's doctor. Tell the doctor right away if the patient has new, worsened, or sudden symptoms, such as depression; anxiety, restlessness, or irritability; panic attacks; or any changes in behavior. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
2.Apremilast may cause weight loss. You will need to have regular weight checks while you are taking apremilast. |
| side effects |
Diarrhea; headache; nausea; weight loss. |
| References |
1. http://www.rheumatology.org/Learning-Center/Publications-Communications/Drug-Safety/Hotline-Apremilast-for-the-Treatment-of-Psoriatic-Arthritis
2. https://www.ncbi.nlm.nih.gov/pubmed/26220911
3. https://www.drugs.com/cdi/apremilast.html
4. http://reference.medscape.com/drug/otezla-apremilast-999915 |
| Definition |
ChEBI: A member of the class of isoindoles that is isoindole-1,3-dione substituted at position 4 by an acetamido group and at position 1 by a 1-(3-ethoxy-4-methoxyphenyl)-2-(methylsulfonyl)ethyl group. Used for treatment of psoriatic arthritis. |
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