Real-world experiences of apremilast in clinics for Japanese patients with psoriasis

Psoriasis, though not an immediately life-threatening disorder, still lowers quality of life and disrupts daily functions. While many treatments for psoriasis exist, few are convenient and safe long term; even if sufficiently effective, treatments themselves often decrease quality of life and make long-term treatment adherence difficult. Approved in Japan in December 2016, apremilast was expected to function as a simple, long-term, systemic therapeutic agent for psoriasis. We report on the clinical outcomes of administrating apremilast for 2 years as observed in 46 psoriatic patients at the Saruwatari Dermatology Clinic between March 2017 and February 2019. We believe the ease of clinic consultation (as compared with large general hospital consultation) draws patients who are busy or have mild symptoms, and consequently poor adherence to regular visits and treatment, reflecting realistic conditions. Major adverse events with apremilast treatment were diarrhea (37.0%) and nausea (15.3%), with most cases of diarrhea being mild. Drug survival analysis by the Kaplan-Meier method revealed a 1-year continuation rate of 46.8% and a 2-year continuation rate of 37.4%. Dermatology Life Quality Index (DLQI) scores during the observation period declined from 9.3 to 2.8 (P < 0.0001) on average, with the DLQI-0/1 achievement rate being 28.6%. Based on our findings, we conclude that apremilast is suitable as a long-lasting basic treatment that is easy to prescribe in small clinics and easy to use in everyday life.