Apremilast
Otezla®
Creatinine. Optional: BB, AST/ALT, CRP, HBs-Ag, HBs-Ak, HBc-Ak, HCV-Screening, HIV, Quantiferontest, X-ray Thorax, SS-Test
p.o.
Initial titration for 5 days (titration pack with 10/20/30mg), then preservation with 30mg 2x a day
2-4 weeks for pruritus, 8 weeks for average PASI50. If no therapeutic effect: STOP after 24 weeks
Renal insufficiency in creatinine clearance < 30 ml/min (reduce to 30 mg/day)
As long as no data on safety in these situations have been published (as of 01.07.2017): Hepatitis B and C, HIV, TB, active infections, malignancies in the last 5 years except treated epithelial skin tumors / cervical dysplasias. Pregnancy, lactation, live vaccinations.
Nausea, diarrhoea (especially in the first 2 weeks), upper airway infections, headache, nasopharyngitis, weight loss (not associated with diarrhoea, average 2kg, 20 % of all patients weight loss of >5 % body weight)
Not limited, long-term data > 5 years still missing
Tbl.
systemic