Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Apremilast has been approved by the FDA for treatment of psoriasis and psoriatic arthritis. Because side effects are few, we decided to use it off-label in a number of patients with extensive cutaneous lupus rashes resistant to topical therapy and hydroxychloroquine, and as a steroid-sparing method.
Methods: We describe 6 patients with significant cutaneous lupus. 2 had subacute cutaneous lupus, and 4 had significant cutaneous lupus rashes which were chronic and associated with systemic lupus. All were treated with the topical corticosteroid clobetasol, and sometimes less-potent corticosteroid preparations for facial involvement. 2 patients were taking oral corticosteroids with a dosage range of 5 to 15. All 6 patients were taking hydroxychloroquine, 400 mg per day. The etiology of the rashes was confirmed by skin biopsy and/or Dermatology and Rheumatology clinical agreement. The mean age was 48; age range was 24 to 74. There were 3 men and 3 women.
Results: Of the 6 patients, 4 responded to apremilast, 30 mg bid, with a significant reduction in erythema and the size and extent of lesions within a 1-month period. Patients were satisfied with the amount of clearing of the lupus rash, and no significant side effects were noted. The 2 patients who did not have a significant reduction in their erythema discontinued apremilast after 6 weeks, and were placed on higher doses of steroids to help control their active lupus rash.
Conclusion: Apremilast may be an effective therapy for patients with resistant extensive rashes due to systemic lupus and subacute cutaneous lupus.
To cite this abstract in AMA style:Katz RS. Apremilast in Patients with Lupus Rashes [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). http://acrabstracts.org/abstract/apremilast-in-patients-with-lupus-rashes-2/. Accessed February 21, 2018.
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