Therapeutic Effects of Apremilast on Enthesitis and Dactylitis in Real Clinical Setting: An Italian Multicenter Study.

Autor: Lo Gullo A; Unit of Rheumatology, Department of Medicine, ARNAS 'Garibaldi', 95124 Catania, Italy., Becciolini A; Internal Medicine and Rheumatology, Department of Medicine, Azienda Ospedaliera Di Parma, 43126 Parma, Italy., Parisi S; Department of General and Specialistic Medicine, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, 10126 Torino, Italy., Del Medico P; Internal Medicine Unit, Civitanova Marche Hospital, 62012 Civitanova Marche, Italy., Farina A; Internal Medicine Unit, Ospedale Augusto Murri-Fermo, 63900 Fermo, Italy., Visalli E; Unit of Rheumatology, Ospedale San Marco, 95121 Catania, Italy., Dal Bosco Y; Unit of Rheumatology, Ospedale San Marco, 95121 Catania, Italy., Molica Colella AB; Unit of Rheumatology, Ospedale Papardo, 98158 Messina, Italy., Lumetti F; Unit of Rheumatology, Azienda Unità Sanitaria Locale di Modena, 41121 Modena, Italy., Caccavale R; Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00185 Roma, Italy., Scolieri P; Unit of Internal Medicine and Rheumatology, ASL Roma 1-Presidio Nuovo Regina Margherita, 00153 Roma, Italy., Andracco R; Asl1 Imperiese, 18100 Sanremo, Italy., Girelli F; Internal Medicine Unit, Ospedale 'Morgagni-Pierantoni' di Forlì, 47121 Forlì, Italy., Bravi E; Department of Rheumatology, Ospedale 'Guglielmo da Saliceto', 29121 Piacenza, Italy., Colina M; Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-Università di Bologna, 40136 Bologna, Italy., Volpe A; Rheumatology Unit, Ospedale Sacro Cuore Don Calabria, 37024 Negrar di Valpolicella, Italy., Ianniello A; SL NOVARA, 28100 Novara, Italy., Ditto MC; Department of General and Specialistic Medicine, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, 10126 Torino, Italy., Nucera V; SL NOVARA, 28100 Novara, Italy., Franchina V; Unit of Rheumatology, Ospedale Papardo, 98158 Messina, Italy., Platé I; Department of Rheumatology, Ospedale 'Guglielmo da Saliceto', 29121 Piacenza, Italy., Di Donato E; Internal Medicine and Rheumatology, Department of Medicine, Azienda Ospedaliera Di Parma, 43126 Parma, Italy., Amato G; Unit of Rheumatology, Ospedale San Marco, 95121 Catania, Italy., Salvarani C; Rheumatology Unit, University of Modena and Reggio Emilia, 41125 Modena, Italy., Bernardi S; Internal Medicine Unit, Ospedale 'Morgagni-Pierantoni' di Forlì, 47121 Forlì, Italy., Lucchini G; Internal Medicine and Rheumatology, Department of Medicine, Azienda Ospedaliera Di Parma, 43126 Parma, Italy., De Lucia F; Unit of Rheumatology, Ospedale San Marco, 95121 Catania, Italy., Molica Colella F; Unit of Rheumatology, Ospedale Papardo, 98158 Messina, Italy., Santilli D; Internal Medicine and Rheumatology, Department of Medicine, Azienda Ospedaliera Di Parma, 43126 Parma, Italy., Mansueto N; Asl1 Imperiese, 18100 Sanremo, Italy., Ferrero G; Asl1 Imperiese, 18100 Sanremo, Italy., Marchetta A; Rheumatology Unit, Ospedale Sacro Cuore Don Calabria, 37024 Negrar di Valpolicella, Italy., Arrigoni E; Department of Rheumatology, Ospedale 'Guglielmo da Saliceto', 29121 Piacenza, Italy., Foti R; Unit of Rheumatology, Ospedale San Marco, 95121 Catania, Italy., Sandri G; Rheumatology Unit, University of Modena and Reggio Emilia, 41125 Modena, Italy., Bruzzese V; Unit of Internal Medicine and Rheumatology, ASL Roma 1-Presidio Nuovo Regina Margherita, 00153 Roma, Italy., Paroli M; Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00185 Roma, Italy., Fusaro E; Department of General and Specialistic Medicine, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, 10126 Torino, Italy., Ariani A; Internal Medicine and Rheumatology, Department of Medicine, Azienda Ospedaliera Di Parma, 43126 Parma, Italy.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2023 Jun 07; Vol. 12 (12). Date of Electronic Publication: 2023 Jun 07.
DOI: 10.3390/jcm12123892
Abstrakt: Introduction: Enthesitis and dactylitis are difficult-to-treat features of psoriatic arthritis (PsA), leading to disability and affecting quality of life.
Objective: The aim of this study is to evaluate enthesitis (using the Leed enthesitis index (LEI)) and dactylitis at 6 and 12 months in patients treated with apremilast.
Methods: Patients affected by PsA from fifteen Italian rheumatological referral centers were screened. The inclusion criteria were: (a) enthesitis or dactylitisphenotype; (b) treatment with apremilast 30 mg bid. Clinical and treatment history, including PsA disease activity, were recorded. Mann-Whitney and chi-squared tests were used to assess the differences between independent groups, and Wilcoxon matched pairs signed-rank test assessed the differences between dependent samples. A p -value of <0.05 was considered statistically significant.
Results: The Eph cohort consisted of 118 patients (median LEI 3); the Dph cohort included 96 patients with a median dactylitis of 1 (IQR 1-2). According to an intention to treat analysis, 25% and 34% of patients with enthesitis achieved remission (i.e., LEI = 0) in T1 and T2. The remission of dactylitis was 47% in T1 and 44% in T2. The per protocol analysis (patients observed for at least 12 months) showed that both dactylitis and LEI significantly improved in T1 (median LEI 1 (IQR 1-3)) and T2 (median LEI 0 (IQR 1-2)).
Conclusion: Eph and Dph PsA patients treated with apremilast experienced a significant improvement in enthesitis and dactylitis activity. After 1 year, enthesitis and dactylitis remission was achieved in more than one-third of patients.
Databáze: MEDLINE
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