Otezla Reviews For Plaque Psoriasis

What Does Otezla Cost

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers, and which pharmacy you use. To find current prices for Otezla in your area, visit WellRx.com.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Otezla manufacturers website to learn about a copay card that may lower the cost of the drug for you.

Below, youll find answers to some commonly asked questions about Otezla.

Who Is Otezla For

Otezla is intended for use in adults with moderate to severe chronic plaque psoriasis who have not responded to, or cannot take other systemic treatments including ciclosporin, methotrexate or PUVA for health reasons.

In Scotland, Otezla can also be used alone or in conjunction with another Disease-Modifying Anti-Rheumatic Drug , for example methotrexate, sulfasalazine or leflunamide, in adults with active psoriatic arthritis, who have not had an acceptable response to another DMARD, or who cannot take another DMARD for health reasons.

In England and Wales, Otezla can be used alone or in combination with other DMARDs in adults with active psoriatic arthritis who:

• Have peripheral arthritis with three or more swollen joints and three or more tender joints
• Have not had an acceptable response to at least two other DMARDs

Effectiveness Of Apremilast With Biologics

According to the LIBERATE trial, the use of apremilast can be considered in biologic-experienced or biologic-naïve patients. However, it is preferred more in biologic-naïve patients, because its efficacy appears to be better in this subgroup of patients.4 Clinical trials reported significantly higher response rates with the use of apremilast in biologic-naïve patients.2

According to published reports,18,19 the cost of biologics is a deterrent in their use in needy patients. Its long-term use adds further to the economic burden on the patients. Considering these factors, panel experts pointed out that in India, there is sparse use of biologics among dermatologists and hence a combination with apremilast would be a sustainable choice for keeping the cost low over long-term therapy.

Regarding the combination therapy of apremilast and biologics, there was a general opinion that it can provide more effective disease control than biologic monotherapy alone. Apremilast could serve as an effective therapeutic option for maintaining remission, induced by biologics. This is corroborated by the findings of two case reports on the effectiveness of combination therapy of apremilast with adalimumab20 and secukinumab,21,22 as well as the personal clinical experience of some of the experts.

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Safety Profile Of Apremilast

Laboratory Monitoring While Using Apremilast

In clinical trials on the efficacy and safety of apremilast, laboratory parameters did not show any significant derangements. Also, there was no evidence of cumulative or organ-specific toxicity.50 According to the prescribing information for apremilast, no laboratory monitoring is required.41 However, in a consensus study on the use of apremilast in psoriasis, published in 2020,8 and a real-world study by Mayba and Gooderham,7 it was recommended that laboratory monitoring should be carried out only in selected cases.

Based on the evidence, clinical experience, and survey results, the experts recommended that:

• Laboratory monitoring in the form of complete blood count should be conducted at least once or twice a year in patients receiving apremilast. In patients on combination therapy, laboratory monitoring guidelines of the other agent should be adhered to.
• Additional laboratory monitoring should be conducted according to the patients underlying disease.
• From the above findings and less rigorous pre-screening, apremilast therapy is more convenient than other conventional therapies.

Common Side Effects of Apremilast

Based on the above findings and clinical experience with the use of apremilast, the experts opined that most of these AEs are mild in severity and resolve with time and appropriate pharmacotherapy, as also noted in the published literature.78

Dose Titration of Apremilast

How Does Otezla Compare To Humira

Otezla and Humira are both used to treat plaque psoriasis and psoriatic arthritis. They each also have other uses.

Unlike Otezla, Humira is a biologic drug. This means Humira is made from parts of living cells. Otezla, on the other hand, is made from chemicals.

Otezla comes as tablets that youll take by mouth twice each day. But youll take Humira as an injection under your skin. Usually, its taken once every 2 weeks, after the first week of treatment.

If you have more questions about the differences between Otezla and Humira, talk with your doctor.

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Patients With Hepatitis B Or C

Similarly to patients with HIV, management of psoriatic patients with chronic infections such as hepatitis B and hepatitis C is challenging because of the increased chances of reactivation of the disease and liver toxicities associated with anti-psoriatic therapies.65

Only three patients with chronic viral hepatitis treated with apremilast have been described in the published literature.62,66,67 From these reports, it was concluded that apremilast was associated with neither reactivation of disease, nor elevation of liver enzymes, nor viral load in active disease. Excessive alcoholism is associated with fatty liver and is also a trigger factor for psoriasis.68 It has been found that apremilast produces stable reductions in voluntary ethanol consumption and is rapidly distributed to plasma and tissues , suggesting its usefulness for medication development and repurposing efforts to treat alcohol misuse.69

Apremilast is not contraindicated in patients with active infections and does not have hepatotoxic effects hence, it can be used in severe hepatic impairment without dose reduction.65

Apremilast exerts an anti-fibrotic action in animal models by inhibiting pro-fibrotic factors such as transforming growth factor- and interleukin-13,70 which could potentially have a positive impact on liver fibrosis. In light of these data, apremilast is not only innocuous but also potentially beneficial in patients with commonly prevalent non-alcoholic fatty liver disease.

What Are The Ingredients In Otezla And Humira

Otezla contains the active drug apremilast. Apremilast belongs to a drug class called disease-modifying antirheumatic drugs .

Humira contains the active drug adalimumab. Adalimumab belongs to a drug class called tumor necrosis factor-alpha blockers.

Otezla and Humira are used to treat some of the same conditions, but they each treat additional conditions as well.

• Otezla and Humira are both used to treat:

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Boxed Warnings For Humira

boxed warning is the most serious warning from the Food and Drug Administration . It alerts doctors and patients about drug effects that may be dangerous.

Serious infections. Humira works by weakening your immune system. Because of this, using Humira could raise your risk for serious infections like tuberculosis that may lead to a hospital stay or death. And if you have an active* infection, using Humira could make it worse. Before you start treatment with Humira, your doctor will test you for TB and check for any other active infections. If you do have an infection, your doctor will likely want to treat it first.

Cancer. Drugs such as Humira can raise your risk for lymphomas and other cancers. Tell your doctor if youve had cancer or any tumors in the past. Theyll determine whether Humira or another treatment might be best for you.

* An infection is active if its currently causing symptoms.

Otezla For Other Conditions

In addition to the uses listed above, Otezla may be used off-label for other uses. Off-label drug use is when a drug thats approved for one use is used for a different one thats not approved. And you may wonder if Otezla is used for certain other conditions. Below is information on other possible uses for Otezla.

Otezla for other forms of psoriasis

There are several forms of psoriasis, but Otezla is only approved to treat plaque psoriasis.

However, Otezla is used off-label for adults with guttate psoriasis, nail psoriasis, palmoplantar psoriasis, pustular psoriasis, and scalp psoriasis. Its not recommended for off-label use in treating erythrodermic psoriasis.

If you have questions about treatment options for psoriasis, talk with your doctor.

Otezla for eczema

Eczema, also called atopic dermatitis, can result in long-lasting or recurring rashes on the face, head, or arms and legs.

In 2012, one small evaluated Otezla for treating adults with eczema and found that it reduced itching and the severity of eczema. However, currently the American Academy of Dermatology doesnt recommend Otezla for treating eczema.

If youd like to know about treatment options for eczema, talk with your doctor.

Otezla for rheumatoid arthritis

Currently, the American College of Rheumatology doesnt recommend Otezla for treating rheumatoid arthritis .

If youd like to learn about treatment options for RA, talk with your doctor.

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Effectiveness Of Apremilast In Special Locations

Currently, apremilast is approved for the treatment of moderate-to-severe psoriasis, but it has shown effectiveness in difficult-to-treat forms of psoriasis, such as scalp, face, palmoplantar, and nail psoriasis, and hence can be considered in these cases.15,23

The ESTEEM 1 AND ESTEEM 2 phase III double-blinded efficacy and safety trials evaluated the efficacy of apremilast in nail and scalp psoriasis.24 Various other studies have also shown the efficacy of apremilast for the treatment of palmoplantar psoriasis25 and nail psoriasis.26

The clinicians in our survey reported the use of apremilast for palmoplantar, scalp, and nail psoriasis, other than plaque psoriasis, as a second-line drug. The panel mentioned its use in nail and palmoplantar types more frequently than in others.

Availability Of Data And Materials

Celgene is committed to responsible and transparent sharing of clinical trial data with patients, healthcare practitioners, and independent researchers for the purpose of improving scientific and medical knowledge as well as fostering innovative treatment approaches. For more information, please visit .

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What Form Does This Medication Come In

10 mgEach pink, diamond-shaped, film-coated tablet, engraved with APR on one side and 10 on the other, contains 10 mg of apremilast. Nonmedicinal ingredients: microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate, polyvinyl alcohol, titanium dioxide, polyethylene glycol, talc, and iron oxide red.

20 mgEach brown, diamond-shaped, film-coated tablet, engraved with APR on one side and 20 on the other, contains 20 mg of apremilast. Nonmedicinal ingredients: microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate, polyvinyl alcohol, titanium dioxide, polyethylene glycol, talc, iron oxide red, and iron oxide yellow.

30 mgEach beige, diamond-shaped, film-coated tablet, engraved with APR on one side and 30 on the other, contains 30 mg of apremilast. Nonmedicinal ingredients: microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, magnesium stearate, polyvinyl alcohol, titanium dioxide, polyethylene glycol, talc, iron oxide red, iron oxide yellow, and iron oxide black.

Who Needs This Medication

The biologics do not cure psoriasis or arthritis caused by psoriasis, but they can relieve symptoms and may help prevent further joint damage.

Some medications such as creams, salves, lotions, sprays, or gels are safer and less expensive than the biologics. Or, if a large part of the body is affected, ultraviolet phototherapy or light therapy may be used.

Some people might not get enough relief with those treatments or they might have joint pain that requires other medications. Other options for treating psoriasis include: acitretin , cyclosporine , and methotrexate . These options also cause serious side effects, and doctors disagree about whether it is better to use one of them before trying a biologic.

Another option is apremilast . This is a new type of medication that was approved by the FDA for treating psoriatic arthritis in early 2014, shortly before this report was being prepared for publication. Unlike biologics, Otezla does not suppress the immune system. Since it is brand new, its long-term safety has not been established. If your doctor recommends any of these drugs, you should ask about the advantages and disadvantages compared with a biologic.

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How Does Otezla Cause Weight Loss

Many people who take Otezla lose weight. There may be several factors that lead to Otezla-related weight loss.

Otezla blocks an enzyme called phosphodiesterase-4 . In addition to its effects on inflammation, this enzyme is involved in energy metabolism. In animals, blocking this enzyme caused them to be leaner, with smaller fat cells. The same effect may apply in humans.

Also, some people who take Otezla may have a reduced appetite or diarrhea as side effects. These effects might also cause weight loss.

Depression Anxiety And Suicidal Tendencies

Depression, anxiety, and suicidal tendencies are common comorbidities among psoriasis patients which may be a result of psychosocial difficulties as well as common inflammatory pathways.35,46,47 However, little is known about whether systemic treatment for psoriasis is associated with an increased risk of anxiety and depression, and whether these risks differ between the various treatments.48

The results of short-term clinical trials and post-marketing cases suggested that apremilast was associated with an elevated risk of depression, anxiety, and suicidal thoughts, to a certain extent.48 According to post-marketing data, out of 105,000 patients who received apremilast, only 65 patients reported either depression and/or suicidal thoughts or behavior, of whom 32 patients improved after discontinuation of therapy.49 Based on these reports, precaution is recommended when prescribing apremilast in patients with a history of depression and/or suicidal thoughts or behavior, as per prescribing information.41

However, Crowley et al, in their long-term safety and tolerability study, reported that apremilast did not increase the incidence of depression.42 Similarly, Vasilakis-Scaramozza et al reported that patients treated with apremilast had a similar risk of depression and anxiety compared to patients on conventional disease-modifying anti-rheumatic drugs or biologic monotherapies.48

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Your Treatment Doesnt Work

Not all treatments work for everyone. Some treatments may not work for you. Topical creams may not help your skin clear up, and some systemic treatments may not bring improvement either.

If youve administered your treatment regularly and given it enough time to work, and you still dont see improvement, it may be time for a change.

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What Are Otezlas Side Effects

Like most drugs, Otezla may cause mild or serious side effects. The lists below describe some of the more common side effects that Otezla may cause. These lists dont include all possible side effects.

Your doctor or pharmacist can tell you more about the potential side effects of Otezla. They can also suggest ways to help reduce side effects.

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Otezla And Other Medications

Below is a list of medications that can interact with Otezla. This list doesnt contain all drugs that may interact with Otezla.

Different drug interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Before taking Otezla, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Drug metabolism inducers

Several medications can make an enzyme called cytochrome P450 3A4 more active in your body. Taking these drugs with Otezla can cause your body to metabolize Otezla more quickly than usual. It can also make Otezla less effective.

Examples of these medications include:

• carbamazepine
• phenobarbital

Herbs and supplements can sometimes interact with medications.

St. Johns wort

St. Johns wort can make an enzyme called cytochrome P450 3A4 more active in your body. Because of this, taking St. Johns wort with Otezla can cause your body to get rid of Otezla more quickly than usual. This can make Otezla less effective.

Taking too much of this medication can increase your risk for serious side effects.

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• 1Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
• 2Department of Dermatology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece

Psoriasis, an inflammatory skin disease, and psoriatic arthritis , an inflammatory arthritis, share clinical, genetic, and pathogenic factors and may be summed as one disease, the psoriatic disease. Interleukin -17 plays a major role in the development of both psoriasis and PsA. IL-23 is important in the proliferation and maintenance of IL-17, and therefore, cytokines of the IL-23/IL-17 axis attracted much interest as therapeutic targets in psoriasis and PsA. Therapeutic agents targeting the IL-23/IL-17 axis have been proven to be very effective in psoriasis and PsA, some are already in the therapeutic armamentarium and others are in the development. Some agents, target IL-23 and others IL-17 and include anti-IL-12/IL-23 p40 , anti-IL-23p19 , anti-IL-17A , dual anti-IL-17A and anti-IL-17F , or anti-IL-17 receptor monoclonal antibodies. Janus tyrosine kinase inhibitors also directly affect IL-23 and, thus, IL-17. After the first-generation pan-JAK inhibitors have been shown efficacy , new-generation selective JAK inhibitors are under investigation in psoriasis and PsA.

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Table 2 How And When To Take A Biologic Drug

Some of the biologics have multiple uses and are also approved for treating other diseases such as ankylosing spondylitis, Crohns disease, rheumatoid arthritis, ulcerative colitis, and other autoimmune diseases.