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Daudén Tello E, Alonso Suárez J, Beltrán Catalán E, Blasco Maldonado C, Herrero Manso MC, Jiménez Morales A, Marín-Jiménez I, Martín-Arranz MD, García-Merino A, Porta Etessam J, Rodríguez-Sagrado MA, Rosas Gómez de Salazar J, Trujillo Martín E, Salgado-Boquete L. Multidisciplinary Management of the Adverse Effects of Apremilast. Actas Dermosifiliogr (Engl Ed) 2020; 112:134-141. [PMID: 32910923 DOI: 10.1016/j.ad.2020.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/31/2020] [Accepted: 08/22/2020] [Indexed: 10/23/2022] Open
Abstract
We present a series of general and specific recommendations based on pathophysiologic considerations for managing the most common adverse effects of apremilast that lead to treatment discontinuation: diarrhea, nausea, and headache. The recommendations are based on a review of the literature and the experience of a multidisciplinary team of 14 experts including dermatologists, rheumatologists, neurologists, gastroenterologists, pharmacists, and nurses. We propose a series of simple algorithms that include clinical actions and suggestions for pharmacologic treatment. The adverse effects of apremilast can be managed from a multidisciplinary approach. The purpose of optimizing management is to bring clinical benefits to patients.
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Affiliation(s)
- E Daudén Tello
- Servicio de Dermatología, Hospital Universitario La Princesa, Madrid, España.
| | - J Alonso Suárez
- Servicio de Dermatología, Hospital Universitario Virgen de la Victoria, Málaga, España
| | - E Beltrán Catalán
- Servicio de Reumatología, Hospital Parc Salut del Mar, Barcelona, España
| | - C Blasco Maldonado
- Unidad de Enfermería, Servicio de Dermatología, Hospital Universitario Puerta de Hierro, Madrid, España
| | - M C Herrero Manso
- Unidad de Enfermería, Servicio de Reumatología, Hospital Universitario 12 de Octubre, Madrid, España
| | - A Jiménez Morales
- Servicio de Farmacia, Hospital Universitario Virgen de las Nieves, Granada, España
| | - I Marín-Jiménez
- Unidad de EII-CEIMI-Servicio de Aparato Digestivo, Hospital Gregorio Marañón, Madrid, España
| | - M D Martín-Arranz
- Servicio de Aparato Digestivo, Hospital Universitario La Paz; Grupo de Inmunidad Innata, Instituto de Investigación IdiPaz, Madrid, España
| | - A García-Merino
- Servicio de Neurología, Hospital Universitario Puerta de Hierro, Madrid, España
| | - J Porta Etessam
- Servicio de Neurología, Hospital Clínico San Carlos, Madrid, España
| | | | | | - E Trujillo Martín
- Servicio Reumatología, Hospital Universitario de Gran Canaria, Las Palmas de Gran Canaria, España
| | - L Salgado-Boquete
- Servicio de Dermatología, Complejo Hospitalario Universitario, Pontevedra, España
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