ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 2724

Apremilast for Refractory Mucocutaneous Ulcers of Behçet’s Disease. National Multicenter Study of 14 Cases

Belén Atienza-Mateo1, José Luis Martín-Varillas1, Javier Loricera1, Nuria Vegas-Revenga1, Lucia C. Domínguez-Casas1, Jose L. Hernández2, Clara Moriano3, Maria Dolores García-Armario4, Iván Castelvi5, Francisca Sivera6, Jaime Calvo-Alen7, Isabel de la Morena8, Francisco Ortiz-Sanjuán9, José Andrés Román-Ivorra9, Ana Pérez-Gómez10, MC Gonzalez-Vela11, Miguel Angel González-Gay1 and Ricardo Blanco12, 1Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Universidad de Cantabria. Spain, Santander, Spain, 2Internal Medicine, Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Universidad de Cantabria. Spain, Santander, Spain, 3Complejo Asistencial Universitario de León, León, Spain, 4Hospital de Xàtiva, Xàtiva, Spain, 5Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, 6Hospital General Universitario de Elda, Elda, Spain, 7Hospital Universitario Araba, Vitoria, Spain, 8Hospital General Universitario de Valencia, Valencia, Spain, 9Hospital La Fe, Valencia, Spain, 10Hospital Príncipe de Asturias, Alcalá de Henares, Spain, 11Pathology Anatomy, Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Universidad de Cantabria. Spain, Santander, Spain, 12Hospital Universitario Marqués de Valdecilla, Santander, Spain

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Behcet's syndrome, treatment and ulcers

  • Tweet
  • Email
  • Print
Session Information

Date: Tuesday, November 7, 2017

Session Title: Vasculitis Poster III: Other Vasculitis Syndromes

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Behçet´s disease (BD) is characterized by recurrent oral and/or genital ulcers accompanied by ocular, cutaneous, articular, gastrointestinal, and/or neurologic manifestations. Oral and/or genital aphthous ulcers are often refractory to conventional treatment. Apremilast is an orally-active small molecule which inhibits phosphodiesterase-4 (PDE-4) that modulates some inflammatory pathways. Our aim was to assess the efficacy of apremilast in BD patients with oral and/or genital ulcers refractory to conventional treatment.

Methods: Retrospective national multicenter open-label study on 14 BD patients treated with apremilast at standard dose of 30 mg twice daily. The main outcome was resolution of oral and/or genital ulcers.

Results: We included 14 patients (10 women/ 4 men), with a mean age of 44.3±14.4 years. Before apremilast, all patients had also received several systemic conventional drugs: oral corticosteroids (n=13), colchicine (n=14), NSAIDS (n=7), methotrexate (n=7), azathioprine (n=5), cyclosporine (n=4), infliximab (n= 3), adalimumab (n=3), dapsone (n=3), mycophenolate mofetil (n=1), tocilizumab (n= 1), etanercept (n=1), secukinumab (n=1). The main clinical symptoms for starting apremilast were oral aphthous ulcers (n=14) and genital ulcers (n=10). Other manifestations present at apremilast onset were arthralgia/arthritis (n=4), folliculitis (n=4), furunculosis (n=1), erythematosus and scaly skin lesions (n=1), psoriasis (n=1), erythema nodosum (n=1), deep venous thrombosis (n=1), ileitis (n=1), asthenia (n=3). Ten patients experienced improvement in the first two weeks after starting apremilast. TABLE shows the evolution of the patients. After a median follow-up of 3.5 [interquartile range, 3-9] months, most of the patients experienced a total or partial clinical improvement. In this period of time, 7 patients developed side-effects: dyspepsia (n=4), nausea (n=3), diarrhea (n=3), headache (n=1), abdominal pain (n=1), anorexia (n=1), and halitosis (n=1). However, only 2 of 6 patients had to reduce the dose of apremilast to 30 mg/day. In 3 patients (21%) apremilast was withdrawn after 3 months of treatment due to unsatisfactory response.

Conclusion: Apremilast leads to a rapid and maintained improvement in many patients with refractory mucocutaneous ulcers of BD. Even in patients refractory to several systemic drugs including biologic therapy.


Table.

Baseline

n= 14

Week 1-2

n= 14

Week 4

n= 11

Week 12

n= 10

Resolution of main symptom,

oral and/or genital ulcers n, (%)

Complete

4/14 (29)

8/11 (73)

7/10 (70)

Partial

6/14 (43)*

2/11 (18)

0/10 (0)

Resolution of others symptoms n, (%)

Complete

3/8 (37)

4/8 (50)

3/7 (43)

Partial

1/8 (12)

2/8 (25)

3/7 (43)

Dose of prednisone (mg/day), median [IQR]

7.5 [0-15] (14)

5.0 [0-10] (14)

7.5 [0-15] (11)

5 [0-5] (9)

The number of patients with available data is shown in parentheses.



Disclosure: B. Atienza-Mateo, None; J. L. Martín-Varillas, None; J. Loricera, None; N. Vegas-Revenga, None; L. C. Domínguez-Casas, None; J. L. Hernández, None; C. Moriano, None; M. D. García-Armario, None; I. Castelvi, None; F. Sivera, None; J. Calvo-Alen, None; I. de la Morena, None; F. Ortiz-Sanjuán, None; J. A. Román-Ivorra, None; A. Pérez-Gómez, None; M. Gonzalez-Vela, None; M. A. González-Gay, None; R. Blanco, None.

To cite this abstract in AMA style:

Atienza-Mateo B, Martín-Varillas JL, Loricera J, Vegas-Revenga N, Domínguez-Casas LC, Hernández JL, Moriano C, García-Armario MD, Castelvi I, Sivera F, Calvo-Alen J, de la Morena I, Ortiz-Sanjuán F, Román-Ivorra JA, Pérez-Gómez A, Gonzalez-Vela M, González-Gay MA, Blanco R. Apremilast for Refractory Mucocutaneous Ulcers of Behçet’s Disease. National Multicenter Study of 14 Cases [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/apremilast-for-refractory-mucocutaneous-ulcers-of-behcets-disease-national-multicenter-study-of-14-cases/. Accessed May 19, 2022.
  • Tweet
  • Email
  • Print

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/apremilast-for-refractory-mucocutaneous-ulcers-of-behcets-disease-national-multicenter-study-of-14-cases/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2022 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.