Apremilast Effective, Safe in Hidradenitis Suppurativa

Symptoms and Presentation
Symptoms and Presentation
Short-term safety and efficacy of apremilast in patients with moderate hidradenitis suppurativa was examined.

Apremilast 30 mg twice daily is an effective anti-inflammatory treatment in patients with hidradenitis suppurativa (HS), according to study results published in the Journal of the American Academy of Dermatology.

The study included participants with moderate HS (n=20). Participants were randomly assigned 3:1 to receive apremilast 30 mg twice daily or placebo for 16 weeks. The primary outcome was Hidradenitis Suppurative Clinical Response (HiSCR) at week 16. Secondary outcomes included Dermatology Life Quality Index (DLQI), as well as participant assessment of pain, itch, and disease burden on a numerical rating scale (NRS) ranging from 0 to 10.

At week 16, 53.3% (n=8) of the participants in the treatment group met the HiSCR end point compared with none in the placebo group (P=.055). Participants in the treatment group also had a significantly lower abscess and nodule count (mean difference −2.6; 95% CI, −6.0 to −0.9; P =.011), NRS for pain (mean difference −2.7; 95% CI, −4.5 to −0.9; P =.009) and itch (mean difference −2.8; 95% CI, −5.0 to −0.6; P =.015) over 16 weeks compared with participants in the placebo group.

The results did not indicate a significant difference in DLQI over time between the treatment and placebo groups (mean difference −3.4; 95% CI, −9.0 to 2.3; P =.230).

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In the apremilast group, the most frequently reported adverse events were mild to moderate headache and gastrointestinal symptoms. No participants dropped out due to adverse events.

“Oral apremilast is a promising treatment option with [a] good short-term safety and tolerability, and could be a valuable addition to the armamentarium for the treatment of hidradenitis suppurativa,” the researchers wrote. “Studies with larger populations and longer follow-up are needed to further elucidate the efficacy and safety profile of apremilast in HS.”

Reference

Vossen ARJV, van Doom MBA, van der Zee HH, Prens PE. Apremilast for moderate hidradenitis suppurativa: results of a randomzed controlled trial [published online July 3, 2018]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.06.046