Apremilast in Patients Difficult to Treat: A Multicentric Real-Life Long-Term Experience

IF 3.7 4区医学 Q1 DERMATOLOGY

Dermatologic Therapy Pub Date : 2023-10-30 DOI:10.1155/2023/9775738

Emanuele Trovato, Eugenio Capalbo, Alessandra Cartocci, Gionata Buggiani, Aldo Cuccia, Alberto Ghilardi, Salvatore Panduri, Imma Savarese, Serena Guiducci, Francesca Prignano

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引用次数: 0

Abstract

Psoriasis is an inflammatory disease nowadays considered not only as a cutaneous but also as a systemic disease. Systemic therapy plays a crucial role in the management of psoriasis. Apremilast is an inhibitor of phosphodiesterase-4 (PDE4), indicated in the treatment of moderate-to-severe psoriasis. Here, we report a multicentric case series of patients treated with apremilast with resolution of skin manifestations and maintenance of clinical response for a minimum of 2 years. By inhibiting PDE4, apremilast acts as a ubiquitous intracellular enzyme, whose active form degrades adenosine cyclic intracellular monophosphate (cAMP) into AMP. The increase in cAMP determines a decrease in proinflammatory cytokines such as TNF-a, IL-17, IL-23, and upregulation of IL-10 with an anti-inflammatory action. Considering the growing incidence of comorbidities in the world population and in particular the strict correlation in patients with psoriasis, it is important to identify therapeutic options able to avoid a negative impact on patients with both conditions. The aim of this work is to highlight the utility of this molecule in the long-term management of these patients. Moreover, these case series further underline the high safety profile and manageability of this small molecule.

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阿普米司特治疗难治性患者:多中心的现实生活长期经验

银屑病是一种炎症性疾病，目前认为不仅是皮肤疾病，而且是全身性疾病。全身治疗在牛皮癣的治疗中起着至关重要的作用。Apremilast是一种磷酸二酯酶-4 (PDE4)抑制剂，用于治疗中重度牛皮癣。在这里，我们报告了一个多中心的病例系列，患者接受阿普米司特治疗，皮肤症状得到缓解，临床反应维持至少2年。通过抑制PDE4，阿普雷米司特作为一种普遍存在的细胞内酶，其活性形式将环细胞内单磷酸腺苷(cAMP)降解为AMP。cAMP的增加决定了促炎细胞因子如TNF-a、IL-17、IL-23的减少和IL-10的上调，具有抗炎作用。考虑到世界人口中合并症的发病率不断上升，特别是牛皮癣患者的严格相关性，确定能够避免对两种疾病患者产生负面影响的治疗方案非常重要。这项工作的目的是强调这种分子在这些患者的长期管理中的效用。此外，这些病例系列进一步强调了这种小分子的高安全性和可管理性。

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来源期刊

Dermatologic Therapy 医学-皮肤病学

CiteScore

7.00

自引率

8.30%

发文量

711

审稿时长

3 months

期刊介绍： Dermatologic Therapy has been created to fill an important void in the dermatologic literature: the lack of a readily available source of up-to-date information on the treatment of specific cutaneous diseases and the practical application of specific treatment modalities. Each issue of the journal consists of a series of scholarly review articles written by leaders in dermatology in which they describe, in very specific terms, how they treat particular cutaneous diseases and how they use specific therapeutic agents. The information contained in each issue is so practical and detailed that the reader should be able to directly apply various treatment approaches to daily clinical situations. Because of the specific and practical nature of this publication, Dermatologic Therapy not only serves as a readily available resource for the day-to-day treatment of patients, but also as an evolving therapeutic textbook for the treatment of dermatologic diseases.