Background/Purpose: Psoriatic arthritis (PsA) is associated with metabolic and cardiovascular disease. Studies have suggested that treatment with apremilast is associated with weight loss and other cardio-metabolic benefits. This study aimed to examine the effects of apremilast on body weight and composition and cardiovascular risk factors in psoriatic arthritis patients.

Methods: Consecutive adults with active PsA initiating apremilast (30 mg twice daily after a step-up regime) were included. Abdominal fat was assessed using Dual Energy X-ray Absorptiometry (DEXA) and disease activity was measured with DAS28-CRP at baseline, 26 and 52 weeks after initiation of apremilast. Data were analyzed using a linear mixed model. Body mass measures were adjusted for alcohol consumption, diarrhea, nausea, smoking, and physical activity.

Results: 44 patients were included, of whom 17 completed the study. Baseline characteristics; mean age 56 years (± 11 SD), median PsA duration five years [range 2–12], and a median BMI of 28 kg/m² [range 24–33].

Following one year of treatment significant reductions were observed in multiple body mass parameters, including a decrease in android fat mass of 1.1 kg (95% CI [–1.7 – –0.5]; p=0.002). Correlation analysis revealed significant correlations between abdominal fat measures and a reduced disease activity, with the strongest correlation for android fat mass (0.309 (95% CI [0.101 – 0.517]; p=0.004). Additionally, in this cohort weight loss correlated with reduced disease activity.

Conclusion: This study demonstrates that apremilast reduces fat mass in PsA patients and indicates beneficial cardiovascular and metabolic effects, reducing the risk for cardiovascular events.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/cardio-metabolic-effects-of-apremilast-in-patients-with-psoriatic-arthritis-a-prospective-cohort-study/