Beneficial effects of apremilast on genital ulcers, skin lesions, and arthritis in patients with Behçet's disease: A systematic review and meta-analysis.

Abstract

OBJECTIVES:

This study aimed to determine the clinical efficacy of apremilast for oral ulcers (OUs), extra-oral manifestations, and overall disease activity in patients with Behçet's disease (BD).

METHODS:

A systematic literature search was performed in PubMed, Embase, Cochrane Library, and Web of Science Core Collection. Studies assessing the treatment effects of apremilast in BD were included. The odds ratios (ORs) of being symptom-free for individual manifestations and mean difference (MD) of Behçet's Disease Current Activity Form (BDCAF) scores were calculated with 95% confidence intervals (CIs) at 12 and 24 weeks using a random-model meta-analysis.

RESULTS:

Of 259 screened articles, eight were included. After 12 weeks of apremilast treatment the OR of symptom-free was as followings: OUs, 45.76 (95% CI, 13.23-158.31); genital ulcers, 4.56 (95% CI, 2.47-8.44); erythema nodosum, 3.59 (95% CI, 1.11-11.61); pseudofolliculitis, 2.81 (95% CI, 1.29-6.15); and arthritis, 3.55 (95% CI, 1.71-7.40). Furthermore, BDCAF scores at 12 weeks were significantly reduced (MD=-1.38; -1.78 to -0.99). However, the proportion of oral-ulcer-free patients increased at 24 weeks (OR = 14.88; 4.81 to 46.07).

CONCLUSIONS:

The currently accumulated data indicate an improvement in mucocutaneous and articular symptoms by short-term apremilast treatment in patients with BD.

• Authors: Yuki Iizuka, Kaoru Takase-Minegishi, Lisa Hirahara, Yohei Kirino, Yutaro Soejima, H O Namkoong, Nobuyuki Horita, Ryusuke Yoshimi, Masaki Takeuchi, Mitsuhiro Takeno, Nobuhisa Mizuki, Hideaki Nakajima
• Journal: Modern rheumatology (Mod Rheumatol) Vol. 32 Issue 6 Pg. 1153-1162 (Oct 15 2022) ISSN: 1439-7609 [Electronic] England
• PMID: 34752620 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)
• Copyright: © Japan College of Rheumatology 2021. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: [email protected].

Chemical References

• Thalidomide
• apremilast

Topics

• Arthritis
• Behcet Syndrome (complications, diagnosis, drug therapy)
• Genitalia
• Humans
• Oral Ulcer (drug therapy, etiology)
• Skin Ulcer
• Thalidomide (analogs & derivatives)
• Ulcer