Apremilast falls under the group of medicines named phosphodiesterase 4 inhibitors, which help to reduce inflammation. The apremilast tablets are approved for the treatment of adult patients with the following conditions:
Active psoriatic arthritis: if a patient cannot use another type of medication called Disease Modifying Antirheumatic Drugs (DMARDs) or when a patient has tried one of these drugs and it was not effective.
Moderate to severe chronic plaque psoriasis: If a patient cannot use one of the following treatment options or when patient have tried one of these treatment option and it was not effective:
- Phototherapy: A treatment option where certain parts of skin are exposed to UV light.
- Systemic therapy: A treatment option that mainly affects the whole body instead of just one local part, such as methotrexate or psoralen.
Behcet’s disease (BD): in order to treat the mouth ulcers which is a bit common complication for individuals with this illness.
Approval: In 2014, Apremilast was approved by the USFDA for the treatment of adults with active psoriatic arthritis and moderate-severe plaque psoriasis.
In 2019, Apremilast was approved for oral ulcers associated with Behçet's disease.
In January 2015, this agent was approved for use in the EU (European Union).
Dosage Form: Apremilast comes in the form of tablets generically and under the brand name Otezla. Apremilast is administered by mouth in tablet form. There are three different existing strengths of apremilast tablets: 10 mg, 20 mg and 30 mg. Sometimes when patients initiate apremilast tablets, they may experience sickness, get indigestion, an upset stomach or diarrhoea. In order to reduce the risk of these events, a healthcare professional will start the treatment with a starter pack which initiates at a much reduced or lower dosage.
Treatment with apremilast will initiate at the lower dose and will gradually be increased or titrated over the initial six days of treatment.
After the period of titration, the usual dose is, apremilast 30 mg twice in a day: one 30 mg tablet in the morning and one 30 mg tablet in the evening. Following day-6 patients will have reached this standard/recommended dose.
Apremilast should be administered without regard to meals. Do not chew, crush, or split, the tablets of apremilast.
Side Effects: Side effects of apremilast are usually mild and not life threatening. The commonly reported side effects during the treatment of psoriatic arthritis may include diarrhea, nausea, and headache.
And the commonly reported side effects during the treatment of psoriasis may include headache, nausea, diarrhea, and upper respiratory tract infection.
Cost: The apremilast cost in India may vary depending on the wholesaler or pharmacy and of course the brand you choose. The cost of an apremilast is around Rs. 295 for a supply of 10 tablets.
