The Medical Letter on Drugs and Therapeutics
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Apremilast (Otezla) for Psoriatic Arthritis

Apremilast (Otezla – Celgene), an oral phosphodiesterase type-4 (PDE4) inhibitor, has been approved by the FDA for treatment of active psoriatic arthritis in adults. It is the first PDE4 inhibitor to be approved for this indication.

STANDARD TREATMENT — Up to 40% of patients with psoriasis develop psoriatic arthritis.1 Nonsteroidal anti-inflammatory drugs (NSAIDs) may be tried first for treatment of mild disease. The disease-modifying antirheumatic drug (DMARD) methotrexate is generally used for treatment of moderate to severe disease. If there is minimal improvement after 12-16 weeks of methotrexate treatment, a tumor necrosis factor (TNF) inhibitor is often added or substituted.2 Ustekinumab (Stelara), a human interleukin-12 and -23 antagonist, has also been approved by the FDA for treatment of active psoriatic arthritis; how ... more      

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