Rates of Anxiety, Depression with Apremilast vs Other Psoriasis Treatments

young man depressed
young man depressed
Apremilast used for the treatment of psoriasis or psoriatic arthritis is not associated with a high risk of incident treated depression, anxiety, or anxiety plus depression.

In patients with psoriasis, those who take apremilast have similar rates of anxiety and depression as patients prescribed other non-corticosteroid systemic psoriasis treatments, according to study results published in the Journal of the European Academy of Dermatology and Venereology.

Little is known about whether systemic treatments for psoriasis and psoriatic arthritis (PsA) are associated with an increased risk for anxiety and depression and whether these risks differ in both treatments. Therefore, the researchers sought to quantify the risk for incident-treated anxiety, depression, and mixed anxiety plus depression in patients treated with apremilast compared with patients prescribed other treatments for psoriasis and PsA.

They found that among the 31,274 patients with psoriasis (43.1% women, median age 49.3 years), patients treated with apremilast alone (n=3913, 12.5%) had a similar risk for incident-treated depression, anxiety, and anxiety plus depression compared with patients treated with conventional disease modifying antirheumatic drugs (n=56511, 20.8%) or biologic monotherapies. In 30,426 patients with PsA (43.6% women, median age 52.9 years), similar rates were noted for incident-treated depression and anxiety plus depression regardless of treatment; however, apremilast alone was associated with a slightly increased risk for treated anxiety compared with other PsA treatments even after adjustment for demographics and history of psychiatric disorders.

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The investigators concluded that, “Overall, the results of this study provide reassurance that apremilast used for the treatment of psoriasis or PsA is not associated with a high risk for incident treated depression, anxiety, anxiety [plus] depression.” They added that, “Among PsA patients, users of apremilast had similar rates of depression and anxiety [plus} depression compared to users of other systemic noncorticosteroid PsA drugs; however, the rate of anxiety was slightly higher.”

Disclosure: This clinical trial was supported by Celgene Corporation (Summit, NJ 07901). Please see the original reference for a full list of authors’ disclosures.

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Vasilakis-Scaramozza C, Persson R, Hagberg KW, Jick S. The risk of treated anxiety and treated depression among patients with psoriasis and PsA treated with apremilast compared to biologics, DMARDs and corticosteroids: a cohort study in the United States MarketScan database [published online January 25, 2020]. J Eur Acad Dermatol Venereol. doi: 10.1111/jdv.16231