Apremilast in Combination With an Interleukin 17A Inhibitor in the Treatment of Recalcitrant Palmoplantar Psoriasis: A Chart Review

Abdulaziz Alomran, Pedro Zancanaro, Lisa Prussick, Minawaer Abudu, Min Ji Her, Courtney Kachuk, Nicole Dumont, Alice B. Gottlieb, David Rosmarin

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: Palmoplantar psoriasis (PPP) is a chronic, immune-mediated, inflammatory disorder affecting the palms and soles. Despite marked improvement in patient outcomes with use of biologic therapies, PPP remains hard to treat as the efficacy of systemic agents does not fully carry over to PPP trials. Methods: The study was approved by the institutional review board of Tufts Medical Center. It is a retrospective chart review of patients seen in Tufts Medical Center’s dermatology outpatient clinic who met the criteria of being diagnosed with PPP and received an anti-interleukin 17 A (IL-17A) concurrently with apremilast for a period of no less than 12 weeks. Four patients who met the criteria were included in the study, and descriptive analysis was performed due to the small sample size. Results: All 4 patients analyzed showed improvement in Palmoplantar Physician Global Assessment (PPPGA) while on combination apremilast and anti-IL17A therapy. Prior to anti-IL17A therapy, the first 3 patients had baseline PPPGAs of mild to severe. They then had PPPGAs of moderate while on anti-IL17A therapy and PPPGAs of clear/almost clear while on the combination of anti-IL17A therapy and apremilast. Patient 4 had a PPPGA of almost clear while on adalimumab, methotrexate, and acitretin and a PPPGA of clear after treatment with ixekizumab, apremilast, and methotrexate. Minimal side effects were reported on combination treatment. Conclusion: All 4 patients who were treated with combination anti-IL17A and apremilast achieved a PPPGA of clear or almost clear. Although the sample size is small, these encouraging results merit further investigation into combination therapy in the treatment of recalcitrant PPP.

Original languageEnglish
Pages (from-to)122-125
Number of pages4
JournalJournal of Psoriasis and Psoriatic Arthritis
Volume3
Issue number4
DOIs
StatePublished - 1 Oct 2018
Externally publishedYes

Keywords

  • apremilast
  • biologic
  • biologic
  • interleukin 17
  • interleukin 17 inhibitor
  • ixekizumab
  • new oral
  • palmoplantar psoriasis
  • psoriasis
  • psoriasis
  • psoriasis
  • psoriasis
  • psoriasis
  • secukinumab
  • treatment
  • treatment
  • treatment

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