Study Reveals Psoriasis Drug May Have Cardiometabolic Benefits in Patients with Psoriatic Disease

New results from a nonrandomized clinical trial show apremilast (Otezla; Amgen Inc.)may provide patients with cardiometabolic disease and psoriasis an added benefit. In a study published in Jama Dermatology, scientists say they discovered the drug may also help patients with psoriasis reduce overall body fat.¹ Visceral fat is stored within the abdominal cavity, and located near several vital organs, including the liver, stomach, and intestines. It can cause several dangerous health conditions, such as diabetes, hypertension, stroke, and cancer.²

Researchers at the Perelman School of Medicine at the University of Pennsylvania measured changes in 70 study participants with moderate to severe psoriasis. Sixty patients completed week 16, and 39 completed 52 of the single-arm, open-label trial conducted between April 2017 and April 2021. The participants all took 30 mg of apremilast, an oral phosphodiesterase-4 (PDE-4) inhibitor approved for treating psoriasis and psoriatic arthritis, twice daily.

The study found no change in aortic vascular inflammation at week 16 (target to background ratio, −0.02; 95% CI, −0.08 to 0.05; P = .61) or week 52 (target to background ratio, −0.07; 95% CI, −0.15 to 0.01; P = .09) compared with baseline. The authors wrote that at week 16, there were reductions in levels of interleukin-1b, fetuin A, valine, leucine, and isoleucine. At week 52, the authors noted reductions in ferritin levels, cholesterol efflux capacity, ß-hydroxybutyrate 16, acetone, and ketone bodies, and an increase in levels of apolipoprotein A-1.

Apremilast was approved by the US Food and Drug Administration in 2014 to treat plaque psoriasis. It has been prescribed to more than 250,000 patients with moderate-to-severe plaque psoriasis or active psoriatic arthritis in the country. Approximately 9 million people in the US suffer from plaque psoriasis, including adolescents and adults.³ Plaque psoriasis affects different parts of the body, including areas like the face, elbows, knees, genitalia, and other areas of skin-to-skin contact.

Study researchers say larger controlled studies are needed to better determine if apremilast is effective at helping psoriasis patients lose weight, because of the small population studied. In the meantime, they urge doctors to screen for cardiovascular disease in psoriasis patients.

References:

1. Gelfand JM, Shin DB, Armstrong AW, et al. Association of Apremilast With Vascular Inflammation and Cardiometabolic Function in Patients With Psoriasis: The VIP-A Phase 4, Open-label, Nonrandomized Clinical Trial. JAMA Dermatol. Published online September 21, 2022. doi:10.1001/jamadermatol.2022.3862

2. Penn Research Finds Psoriasis Medication Apremilast Leads to Fat Loss in People with Psoriasis.Pennmedicine.org. Accessed September 28, 2022. https://www.pennmedicine.org/news/news-releases/2022/september/medication-apremilast-leads-to-fat-loss-in-people-with-psoriasis

3. Gao JC, Wu AG, Contento MN, Maher JM, Cline A. Apremilast in the Treatment of Plaque Psoriasis: Differential Use in Psoriasis. Clin Cosmet Investig Dermatol. 2022; 15:395-402. Published 2022 Mar 8. doi:10.2147/CCID.S266036