scholarly journals Efficacy and Safety of Apremilast versus Methotrexate in the Treatment of Chronic Plaque Psoriasis

2021 ◽  
Vol 16 (1) ◽  
pp. 39-41
Author(s):  
Tawhida Nawazesh Rosie ◽  
Abdul Latif Khan ◽  
Md Shirazul Islam Khan ◽  
Quazi Salim Yazdi ◽  
ATM Rezaul Karim

Introduction: Psoriasis is a common, chronic, inflammatory and proliferative disease of the skin, also affecting nail and joints. Although there are a range of treatment options available, none have proved to wane the symptoms fully and also they reappear in course of time. Aim: To explore the safety and efficacy of Apremilast and Methotrexate on chronic plaque psoriasis patients. Methods: A randomized open clinical trial was done among fifty clinically diagnosed chronic plaque psoriasis patients in the Department of Dermatology and Venereology at Combined Military Hospital (CMH), Dhaka from 1st July 2017 to 30th June 2018. Patients were divided randomly into two equal treatment groups, 25 for Methotrexate and 25 for Apremilast. Involvement of body surface by plaque psoriasis, erythema, scaling and induration were recorded in a 3 points scale before treatment and 8 weeks after starting the treatment and finally at 12th week. Results: Reduction of psoriasis at 1st follow up in Methotrexate and Apremilast groups were 29.9±9.0 and 31.9±11.6 respectively and at 2nd follow up were 85.9±7.3 and 28.48±39.3 respectively. Significantly higher improvements were observed in Methotrexate group than Apremilast group both at 1st and 2nd follow up (p=0.001). Conclusion: Methotrexate is a better therapeutic option than Apremilast in the treatment of chronic plaque psoriasis. JAFMC Bangladesh. Vol 15, No 1 (June) 2020: 39-41

2020 ◽  
Vol 14 (2) ◽  
pp. 87-90
Author(s):  
Sadaf Amin Chaudhry ◽  
Nadia Ali Zafar ◽  
Rabia Hayat ◽  
Ayesha Noreen ◽  
Gulnaz Ali ◽  
...  

Background: Acne is the eighth most prevalent disease affecting 9.4% of the population worldwide and its prevalence in our country is estimated to be around 5%. Severe inflammatory acne is most likely to leave scars and in order to prevent facial disfigurement due to acne scarring, early treatment is desirable. Various treatment options have been formulated for acne, and are tailored according to the severity of the disease. Numerous clinical trials have been conducted till now, to determine the usefulness and side effect profile of such therapies, making acne treatment a highly studied area in dermatology. Objective of this study is to highlight the fact that oral Dapsone could be used as a cheaper alternate to isotretinoin in recalcitrant severe acne, especially in females where retinoids are sometimes contraindicated. Patients and methods: 51 patients, suffering from severe nodulocystic acne, fulfilling the criteria, were enrolled from the Department of Dermatology, Sir Ganga Ram Hospital, Lahore. All the study patients were given oral Dapsone 50mg for initial two weeks and then 100mg daily for the next 10 weeks along with oral cimetidine and topical clindamycin application twice daily. Investigator Global Assessment Scale (IGAS) was employed to measure effectiveness. The treatment was considered ʽeffectiveʹ if the patient achieves 2 or more than 2-grade improvement or almost clear or clear skin at the end of 12 weeks according to IGAS scale. The lesion counts were also done before the start of therapy (day 1) and at every two weeks follow up for 12 weeks. The change in lesion count observed between the baseline number and that seen at follow up visits was also used to evaluate the effectiveness of oral Dapsone. Safety was analyzed by fortnightly visits of the patients to look for any undesirable side effects and monitoring of the hematologic profile of the patients. Final follow up was done at the end of 16 weeks. Results: The study was conducted on 51 patients, with a ratio of 1:3 for males and females and a mean age of 25.2 years (SD ±5.81). At 12th week, patients had significant reduction in their acne lesions; with 7 patients (13.7%) showing completely clear skin, 17 patients (33.3%) had almost clear skin, 5 patients (9.8%) had 3-grade improvement. Twelve patients (23.5%) had 2-grade improvement from baseline score and only 2 patients (3.9%) had 1-grade improvement from baseline. Based on percentage reduction of lesions, excellent response was seen in 32 patients (62.7%), good response in 9 patients (17.6%), moderate response in 2 patients (3.9%), while no patient showed poor response. Dapsone was discontinued in 8 patients due to derangement of hematologic profile. Conclusion: Oral Dapsone, when given carefully, is a very effective therapeutic option in severe recalcitrant acne, with limited side effects.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1485.3-1485
Author(s):  
F. Carubbi ◽  
A. Alunno ◽  
P. Cipriani ◽  
V. Pavlych ◽  
C. DI Muzio ◽  
...  

Background:Over the last 2 decades rituximab (RTX) has been widely used, albeit off-label, in primary Sjögren’s syndrome (pSS). Several studies reported that B-lymphocyte depletion with RTX is effective in this disease not only by reducing disease activity but also by affecting the inflammation and the lymphoid organization that occur in target tissues. With the recent release of several RTX biosimilars (bRTX) on the market, the demonstration of their interchangeability with RTX originator (oRTX) is required.Objectives:To compare efficacy and safety of oRTX and bRTX in pSS patients in a real-life setting.Methods:Clinical records of pSS patients referring to a tertiary rheumatology clinic were retrospectively evaluated. Patients having received at least 2 courses of either oRTX or bRTX (1000 mg IV infusion, repeated after 2 weeks -1 course- and the course repeated after 24 weeks) with complete data at baseline and after 3, 6, 9 and 12 months of treatment were enrolled. Disease activity was assessed with the EULAR SS disease activity index (ESSDAI) and its clinical version without the biological domain (ClinESSDAI). Patient-reported symptoms were assessed with the EULAR SS Patient Reported Index (ESSPRI).Results:Seven patients that received oRTX and 7 patients that received bRTX were enrolled. Baseline clinical features, including ESSDAI and ESSPRI were similar in the 2 treatment groups. Both compounds significantly reduced ESSDAI and ESSPRI as early as 3 months and no difference between the groups was observed at any time point (Figure 1). Of interest, ESSDAI slowly decreased until month 6 when the most pronounced reduction was observed. Conversely, ESSPRI dropped to its lowest values already at month 3. With regard to safety, at 12 months of follow-up no adverse event was observed in any of the treatment groups.Conclusion:At 12 months of follow-up, oRTX and bRTX display similar efficacy and safety profiles. The improvement of patient reported outcomes is faster than the improvement of disease activity with both compounds. Our data support interchangeability of oRTX and bRTX in pSS.References:[1]Carubbi F et al. Arthritis Res Ther. 2013;15(5):R172[2]Carubbi F et al. Lupus. 2014;23(13):1337-49Figure 1 ESSDAI and ESSPRI values at every time point in the 2 treatment groups. Asterisks indicate p values <0.05 compared to the other treatment group at the same time pointDisclosure of Interests:Francesco Carubbi Speakers bureau: Francesco Carubbi received speaker honoraria from Abbvie and Celgene outside this work., Alessia Alunno: None declared, Paola Cipriani Grant/research support from: Actelion, Pfizer, Speakers bureau: Actelion, Pfizer, Viktoriya Pavlych: None declared, claudia di muzio: None declared, Roberto Gerli: None declared, Roberto Giacomelli Grant/research support from: Actelion, Pfizer, Speakers bureau: Abbvie, Roche, Actelion, BMS, MSD, Ely Lilly, SOBI, Pfizer


2021 ◽  
Vol 85 (3) ◽  
pp. AB59
Author(s):  
Christine Bodemer ◽  
Andrzej Kaszuba ◽  
Külli Kingo ◽  
Athanasios Tsianakas ◽  
Akimichi Morita ◽  
...  

2011 ◽  
Vol 12 (3) ◽  
pp. 191-201 ◽  
Author(s):  
Luigi Naldi ◽  
Nikhil Yawalkar ◽  
Andrzej Kaszuba ◽  
Jean-Paul Ortonne ◽  
Paolo Morelli ◽  
...  

2020 ◽  
Vol 61 (4) ◽  
Author(s):  
William Berry ◽  
Benjamin Daniel ◽  
Rebecca Nguyen ◽  
Chris Baker ◽  
Peter Foley

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