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Observational Study
. 2022 Oct;41(10):3219-3225.
doi: 10.1007/s10067-022-06255-3. Epub 2022 Jul 7.

Apremilast retention rate in clinical practice: observations from an Italian multi-center study

Alarico Ariani  1 , Simone Parisi  2 , Patrizia Del Medico  3 , Antonella Farina  4 , Elisa Visalli  5 , Aldo Biagio Molica Colella  6 , Federica Lumetti  7 , Rosalba Caccavale  8 , Palma Scolieri  9 , Romina Andracco  10 , Francesco Girelli  11 , Elena Bravi  12 , Matteo Colina  13 , Alessandro Volpe  14 , Aurora Ianniello  15 , Veronica Franchina  16 , Ilaria Platè  12 , Eleonora Di Donato  17 , Giorgio Amato  5 , Carlo Salvarani  18 , Gianluca Lucchini  17 , Francesco De Lucia  5 , Francesco Molica Colella  19 , Daniele Santilli  17 , Giulio Ferrero  20 , Antonio Marchetta  14 , Eugenio Arrigoni  12 , Flavio Mozzani  17 , Rosario Foti  5 , Gilda Sandri  18 , Vincenzo Bruzzese  9 , Marino Paroli  8 , Enrico Fusaro  2 , Andrea Becciolini  17
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Observational Study

Apremilast retention rate in clinical practice: observations from an Italian multi-center study

Alarico Ariani et al. Clin Rheumatol. 2022 Oct.

Abstract

Objective: There are few real-world setting studies focused on apremilast effectiveness (i.e., retention rate) in psoriatic arthritis (PsA). The main aim of this retrospective observational study is the assessment of apremilast 3-year retention rate in real-world PsA patients. Moreover, the secondary objective is to report the reasons of apremilast discontinuation and the factors related to treatment persistence.

Methods: In fifteen Italian rheumatological referral centers, all PsA consecutive patients who received apremilast were enrolled. Anamnestic data, treatment history, and PsA disease activity (DAPSA) at baseline were recorded. The Kaplan-Meier curve and the Cox analysis computed the apremilast retention rate and treatment persistence-related risk factors. A p-value < 0.05 was considered statistically significant.

Results: The 356 enrolled patients (median age 60 [interquartile range IQR 52-67] yrs; male prevalence 42.7%) median observation period was 17 [IQR 7-34] months (7218 patients-months). The apremilast retention rate at 12, 24, and 36 months was, respectively, 85.6%, 73.6%, and 61.8%. The main discontinuation reasons were secondary inefficacy (34% of interruptions), gastro-intestinal intolerance (24%), and primary inefficacy (19%). Age and oligo-articular phenotype were related to treatment persistence (respectively hazard ratio 0.98 IQR 0.96-0.99; p = 0.048 and 0.54 IQR 0.31-0.95; p = 0.03).

Conclusion: Almost three-fifths of PsA patients receiving apremilast were still in treatment after 3 years. This study confirmed its effectiveness and safety profile. Apremilast appears as a good treatment choice in all oligo-articular PsA patients and in those ones burdened by relevant comorbidities. Key Points • Apremilast retention rates in this real-life cohort and trials are comparable. • The oligo-articular phenotype is associated with long-lasting treatment (i.e., 3 years). • No different or more prevalent adverse events were observed.

Keywords: Apremilast; Drug retention rate; Psoriatic arthritis.

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References

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