Apremilast Add-On Benefits Over Conventional Drugs (ABCD) in Unstable Non-segmental Vitiligo: A 12-Week Single-Center Randomized Controlled Trial.
apremilast
autoimmune diseases
bsa
dlqi
non-segmental vitiligo
phosphodiesterase 4 inhibitors
unstable vitiligo
vasi
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
accepted:
05
04
2023
medline:
8
5
2023
pubmed:
8
5
2023
entrez:
8
5
2023
Statut:
epublish
Résumé
Background Apremilast is an oral phosphodiesterase-4 enzyme inhibitor that modulates the immune system by increasing intracellular cyclic adenosine monophosphate levels and inhibiting inflammatory cytokines synthesis. We aimed to compare the efficacy and safety of add-on apremilast in combination therapy with standard treatment in patients with unstable, non-segmental vitiligo. Methods The study was a 12-week randomized, controlled, parallel-group, open-labeled trial. The control group received standard treatment (n=15), and the intervention group received 30 mg apremilast twice daily in addition to standard treatment (n= 16). Time to the first sign of re-pigmentation, halt in progression, and change in vitiligo area scoring index (VASI) score is the primary outcomes. Normality was assessed, and appropriate parametric and nonparametric tests were undertaken. Results Thirty-seven participants were randomized into two groups, and analysis was done on thirty-one participants. Over the treatment duration of 12 weeks, the median time to observe the first sign of re-pigmentation was four weeks in the add-on apremilast group compared to seven weeks in the control group (p=0.018). The halt in progression was observed more in the add-on Apremilast group (93.75%) compared to the control group (66.66%) (p=0.08). The VASI score decreased by 1.24 in the add-on apremilast group and 0.05 in the control group (p= 0.754). Parameters including body surface area, dermatology life quality index, and body mass index reduced significantly, while the visual analog scale increased significantly in the add-on apremilast group. However, results were comparable between groups. Conclusions Treatment with add-on apremilast accelerated clinical improvement. It also reduced disease progression and improved the disease index among participants. However, add-on apremilast had a lower tolerability profile than the control group.
Identifiants
pubmed: 37153322
doi: 10.7759/cureus.37180
pmc: PMC10162885
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e37180Informations de copyright
Copyright © 2023, Sharma et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Int J Dermatol. 2012 Oct;51(10):1206-12
pubmed: 22458952
Indian Dermatol Online J. 2019 Jan-Feb;10(1):38-44
pubmed: 30775297
Dermatology. 2020;236(6):571-592
pubmed: 32155629
J Invest Dermatol. 2020 Aug;140(8):1498-1500
pubmed: 32709274
Clin Exp Dermatol. 2022 Dec;47(12):2136-2149
pubmed: 35974705
Indian J Community Med. 2014 Jul;39(3):143-6
pubmed: 25136154
J Eur Acad Dermatol Venereol. 2023 Feb;37(2):348-355
pubmed: 36300769
Case Rep Dermatol Med. 2017;2017:2386234
pubmed: 29234546
Dermatol Ther. 2020 Nov;33(6):e14261
pubmed: 32876993
G Ital Dermatol Venereol. 2020 Aug;155(4):386-399
pubmed: 33050680
Dermatol Ther (Heidelb). 2020 Dec;10(6):1185-1198
pubmed: 32949337
N Engl J Med. 2019 Nov 14;381(20):1918-1928
pubmed: 31722152
Arch Dermatol Res. 2023 Mar;315(2):215-221
pubmed: 35279741
J Invest Dermatol. 2020 Aug;140(8):1533-1537.e2
pubmed: 32004567
Drugs. 2017 Mar;77(4):459-472
pubmed: 28213862
J Am Acad Dermatol. 2021 Dec;85(6):1657-1660
pubmed: 33440217
Front Pharmacol. 2018 Oct 17;9:1048
pubmed: 30386231
Indian J Dermatol Venereol Leprol. 2002 Mar-Apr;68(2):92-3
pubmed: 17656888
Dermatol Ther. 2019 Sep;32(5):e13064
pubmed: 31414705
J Am Acad Dermatol. 2020 Jul;83(1):96-103
pubmed: 32032692
Dermatol Ther. 2019 Jul;32(4):e12923
pubmed: 30977956
J Am Acad Dermatol. 2008 Oct;59(4):713-7
pubmed: 18793940
Ther Adv Musculoskelet Dis. 2010 Oct;2(5):271-8
pubmed: 22870453