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New Drug for Psoriatic Arthritis

Darrell Hulisz, RPh, PharmD
Erin Waehner, Doc

October 9, 2014

Otezla (apremilast) is a new drug recently approved by the FDA for the treatment of both psoriatic arthritis and plaque psoriasis. Apremilast works by inhibiting phosphodiesterase 4 (PDE4) which increases intracellular cAMP levels and regulates many inflammatory mediators such as nitric oxide synthase, TNF- ?, IL-23 and IL-10. Clinical trials with apremilast in patients with psoriatic arthritis showed an improvement of standardized scores (ACR20), joint swelling and tenderness and improved physical functionality. This improvement was seen in about four months with most patients.

The oral dose for adults for psoriatic arthritis is titrated as follows: Day 1-10mg daily; Day 2-10mg BID; Day 3-10mg QAM and 20mg QHS; Day 4-20mg BID; Day 5-20mg QAM and 30 mg QHS; Day 6 and thereafter-30mg BID. Apremilast can be taken without regard to food or drink. The primary side effects include headache, weight loss, nausea, vomiting and diarrhea, an increase in upper respiratory tract infections and an increase in depression has been seen in clinical trials. Health care providers will also want to monitor interactions with CYP3A4 inducers.

Apremilast is being made available in a titration pack with 10mg, 20mg & 30mg, and also in bottles of 60 of the 30mg strength. The drug is available as film-coated, non-scored tablets. This product is only available through specialty pharmacies. To request forms or for additional information regarding prescribing and access, call 1-844-468-3952 or visit http://www.otezla.com.