Product Theater: Otezla for Psoriasis
Dr. Paul Wallace presents on Otezla for psoriasis and psoriatic arthritis and reminds us all to treat the patient, not just the disease. The lecture, sponsored by Celgene Pharma, was part of the 2014 SDPA Fall Conference in San Diego.
Dr. Paul Wallace presented on behalf of Celgene Pharmaceuticals to educate on plaque psoriasis and the benefits of Otezla (apremilast) as part of a treatment regimen.
Dr. Wallace explained that psoriasis is a common, chronic, immune-mediated, inflammatory disease of the skin that affects 2% of the population. Plaque psoriasis and psoriatic arthritis are common forms seen in 85-90% and 30% of psoriasis patients respectively. Surveys show that many individuals who suffer from psoriasis feel that they are being undertreated for their condition. Dr. Wallace noted that according to survey reports, 51% of psoriasis patients are dissatisfied with treatment and less than 10% of patients are actually HAPPY with their treatment.
So what is available to our patients? Topical agents include moisturizers, topical steroids, tar preparations, dithranol, vitamin D, and vitamin A analogues. For phototherapy, UVA/B and PUVA are used, and for systemic therapy there are conventional options (methotrexate, cyclosporine, and acitretin) as well as biologic opions (TNF inhibitors, IL-12, IL-23). Dr. Wallace added, “But there is a new kid on the block.” It’s an oral PDE4 Inhibitor called Otezla (apremilast).
Otezla is indicated for the treatment of patients with moderate to severe plaque psoriasis who are candidates for phototherapy or systemic therapy as well as adult patients with active psoriatic arthritis. It is clinically proven to decrease lesional skin epidermal thickness, expression of proinflammatory genes, and inflammatory cell infiltration.
Otezla comes with warning and precaution for depression. Dr. Wallace suggests asking your patients about their history of depression and hearing their stories on exactly how psoriasis affects their mental condition. Otezla package insert supplies information from a clinical study. In the study cohort, 12/920 Otezla patients reported depression compared to 2/506 on placebo. Serious depression was reported in 1 of 1308 Otezla patients compared to 0/506 of the placebo patients.
Suicidal behavior was seen in 1 of 1308 on Otezla compared to 1/506 of the placebo patients. One patient of the placebo committed suicide.
The insert also warns of weigh loss. Dr. Wallace mentioned that this could simply be from the positive effects of symptom reduction. Perhaps once these patients experienced some clearance, they started to care about their lives – what they ate, the activities they engaged in, etc. In the study, body weight loss of 5-10% occurred in 96 of 784 patients treated with Otezla and in 19 of the 382 on the placebo.
The Otezla summary shows evidence that there is truly no other drug of its kind. Here’s the run-down:
- Otezla offers a different mechanism of action
- It is an oral systemic drug
- Otezla demonstrated significant improvement in PASI-75 response rate vs placebo at week 16 in patients with moderate to severe plaque psoriasis
- The most common (>5%) adverse reactions were diarrhea and nausea, however these subsided after 2 weeks in most patients
- Otezla is also approved for adults with active psoriatic arthritis
- Moreover, Otezla SupportPlus has been designed to help both you and your patients with education, prescriptions, and insurance. For more
information on SupportPlus, call 1-844-4OTEZLA
Dr. Wallace concluded his talk with messages from the heart. “I really would like you to reconsider that psoriasis is more than just a skin disease,” he said. “I hope you utilize in whatever communication you have to talk about psoriasis. So many patients are not getting treated for psoriasis or are undertreated. Treat the patient, not just the disease.”