I had been interested in apremilast in psoriatic
and rheumatoid athritis. Now, there’s a new development: apremilast is tested
for treatment of ankylosing spondylitis. Apremilast is an oral phosphodiesterase 4
inhibitor (PDE-4), which modulates inflammatory mediators.
E. Pathan and colleagues “just” published a
study with the title: “Efficacy and safety of apremilast, an oral
phosphodiesterase 4 inhibitor, in ankylosing spondylitis”. They concluded: “Although
a small pilot study, these results suggest that apremilast may be effective and
well tolerated in AS and modulates biomarkers of bone biology. These data
support further research of apremilast in axial inflammation.” But if you look
at the result part, you get disenchanted: “Although the primary end-point
(change in BASDAI at week 12) was not met, apremilast was associated with
numerically greater improvement from baseline for all clinical assessments
compared with placebo with mean change in BASDAI (-1.59±1.48 vs -0.77±1.47),
BASFI (-1.74±1.91 vs -0.28±1.61) and BASMI (-0.51±1.02 vs -0.21±0.67); however,
differences did not achieve statistical significance.” CRP didn’t change, no
difference between verum and placebo groups. The data might also suggest stopping
further testing.
The authors argue to conduct a suitably powered
study, because of the “current lack of effective oral DMARDs in AS”.
I’m happy that I don’t have to decide as I’m
sceptical about apremilast in treating ankylosing spondylitis. Maybe apremilast
will be useful against psoriatic arthritis, so it won’t be the last we hear on
apremilast, but that’s another story.
Links:
Psoriatic Arthritis: http://rheumatologe.blogspot.de/2012/12/psoriatic-arthritis-at-acr-2012-in.html
Rheumatoid Arthritis and others: http://rheumatologe.blogspot.de/2012/01/efficacy-and-safety-of-apremilast-oral.html
Ankylosing Spondylitis: http://www.ncbi.nlm.nih.gov/pubmed/22984171
No comments:
Post a Comment