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Apremilast May Help With Biologic Fatigue

A small, single-center, retrospective study showed adding apremilast (Otezla) to biologic therapy was a safe and effective option for addressing biologic fatigue among patients with psoriasis.

“Biologics have been shown to constitute a highly effective treatment for patients with psoriasis. However, a significant number of patients treated with biologics will discontinue them due to loss of efficacy over time, a phenomenon known as biologic fatigue or secondary failure,” the researchers said.

In a retrospective study, they investigated whether adding apremilast to biologic therapy among 14 patients with psoriasis enrolled at a single hospital. Prior to initiating apremilast, the mean Psoriasis Area and Severity Index (PASI) score was 3.2 ± 0.4.
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After 24 weeks of treatment with apremilast, the mean PASI score decreased to 1.6 ± 0.3, the researchers said. They found 4 (29%) patients achieved 75% reduction in PASI score, and 7 (50%) patients achieved 50% reduction in PASI score.

Common side effects reported during the 24 weeks of treatment included diarrhea (n=4), combined diarrhea and nausea (n=1), and weight loss of more than 5% bodyweight (n=2). However, none of the patients discontinued treatment due to adverse effects, the researchers added.

“These results suggest that the combination therapy of apremilast and biologics could be a safe, effective option for the management of patients with psoriasis showing biologic fatigue,” they concluded.


Takamura S, Sugai S, Taguchi R, Teraki Y. Combination therapy of apremilast and biologics in patients with psoriasis showing biologic fatigue [published online December 22, 2019]. J Dermatol. doi:10.1111/1346-8138.15193

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