Possibility of combined therapy with an oral phosphodiesterase-4 inhibitor (apremilast) and dihydrofolatereductase inhibitor (methotrexate) in patients with psoriatic arthritis plaque psoriasis

2019 ◽  
Vol 74 (5) ◽  
pp. 292-298
Author(s):  
Alexey A. Kubanov ◽  
Olga G. Artamonova ◽  
Arfenya E. Karamova
Keyword(s):  
Psoriatic Arthritis ◽  
Combination Therapy ◽  
Plaque Psoriasis ◽  
Combined Therapy ◽  
Efficacy And Safety ◽  
Severe Plaque Psoriasis ◽  
Phosphodiesterase 4 ◽  
Significant Clinical Improvement ◽  
Phosphodiesterase 4 Inhibitor ◽  
Clinical Cases

Background: Data on the possible combinations of apremilast with other types of psoriasis therapy is limited. Description of clinical cases: We present the data on the efficacy and safety of combination therapy of the selective phosphodiesterase 4 inhibitor and dihydrofolatereductase inhibitor (methotrexate) for the treatment of psoriasis and psoriatic arthritis in patients with moderate-to-severe plaque psoriasis and active psoriatic arthritis with lack of efficacy of methotrexate in the anamnesis. The selective phosphodiesterase 4 inhibitor (apremilast) was administered according to the prescription. The severity psoriatic arthritis of was estimated by PASI. The effectiveness of therapy was evaluated at week 14. Due to the lack of effect, methotrexate was added subcutaneously at week 14. The effectiveness of combination therapy was assessed at week 26. In both cases, the significant clinical improvement was reached (patients reached PASI 75 and PASI 90), a decrease of the psoriatic arthritis activity according to the DAS28 and DAPSA. Conclusion: These clinical cases demonstrate the efficacy and safety of combined therapy with methotrexate and apremilast inpatients with active psoriatic arthritis and moderate to severe plaque psoriasis.

scholarly journals EFFICACY OF NARROWBAND ULTRAVIOLET B 311 NM PLUS AN INHIBITOR OF PHOSPHODIESTERASE 4 (PDE4) COMBINED THERAPY IN PATIENTS WITH MODERATE TO SEVERE PLAQUE PSORIASIS

2019 ◽  
Vol 22 (5-6) ◽  
pp. 149-155
Author(s):  
Olga Yu. Olisova ◽  
E. V Grekova ◽  
D. A Svistunova
Keyword(s):  
Side Effects ◽  
Treatment Regimen ◽  
Plaque Psoriasis ◽  
Combined Therapy ◽  
Severe Psoriasis ◽  
Ultraviolet B ◽  
Control Group ◽  
Severe Plaque Psoriasis ◽  
Phosphodiesterase 4 ◽  
Study Participants

Objective. to determine the effectiveness and tolerability of narrowband ultraviolet (UV) B (311 nm) plus an inhibitor of phosphodiesterase 4 (PDE4) combined therapy in patients with moderate to severe plaque psoriasis. Material and methods. the first group consisted of 30 patients (18 women and 12 men) who were treated with UVB 311 nm and inhibitor of phosphodiesterase 4 (PDE4). The second (control) group was treated with UVB 311 nm and methotrexate (n = 30; 15 women and 15 men). The study participants were aged 32 to 67 (43.8 ± 4.34). Results. it was determined greater efficiency (PASI 100 43.3% of patients and PASI 90 46.7%) of the treatment plaque moderate to severe psoriasis patients with UVB 311 nm plus an inhibitor of PDE4 compared to UVB 311 nm plus methotrexate (PASI 100 10% of patients and PASI 90 40%). The treatment was well-tolerated. The side effects in both groups were mild, did not require the cancellation of the prescribed treatment regimen, and were often stopped on their own or with minimal corrective therapy.

scholarly journals EFFICACY OF SELECTIVE PDE-4 INHIBITOR IN PATIENTS WITH PSORIASIS: CLINICAL OBSERVATIONS

2018 ◽  
Vol 73 (2) ◽  
pp. 81-87 ◽  
Author(s):  
A. A. Kubanov ◽  
A. Е. Karamova ◽  
O. G. Artamonova
Keyword(s):  
Quality Of Life ◽  
Psoriatic Arthritis ◽  
Plaque Psoriasis ◽  
Nail Plate ◽  
Nail Psoriasis ◽  
Severe Plaque Psoriasis ◽  
Clinical Observations ◽  
Significant Clinical Improvement ◽  
Negative Side Effects

Objective: We aim to present preliminary on about the efficacy of a new drug for plaque psoriasis and psoriatic arthritis treatment - an oral selective PDE-4 inhibitor (apremilast) in 3 psoriasis patients and evaluate apremilast efficacy and safety.Materials and methods: The study enrolled patients with moderate-to-severe plaque psoriasis and psoriatic arthritis who demonstrated lack of efficacy, negative side effects or intolerance to systemic therapy with methotrexate, acitretin, and phototherapy in anamnesis. Patients were administered with apremilast according to the prescription (start 10 mg daily, stepwise increase to 30 mg taken orally twice a day). The severity was estimated by PASI, BSA, sPGA, ptPGA; the patient’s quality of life was determined by DLQI. The efficacy was evaluated at week 14.Results: All patients reached significant clinical improvement (two patients reached ΔPASI50, one patient ΔPASI75, improvement of the nail plate state).Conclusion: According to our observations, apremilast is safe and effective for the treatment of moderate-to-severe plaque psoriasis, scalp and nail psoriasis, and psoriatic arthritis.

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