AB0920 Safety of Apremilast in PsA patients with history of malignancies or active cancer: a retrospective study

Background

One of the most intriguing aspects in the management of patients with inflammatory arthritis is the safety of novel therapies in those with a recent history of malignancy or active neoplasm. In this regard, apremilast (APR), an oral PDE4 inhibitor, is emerging as one of the safest therapeutic options in patients with PsA with comorbid cancer.

Objectives

This retrospective study aims to assess the effectiveness and safety of APR in PsA patients with a recent history of malignancy or active cancer.

Methods

We retrospectively observed patients with a history of neoplasm diagnosed from 1997 to 2021, who underwent apremilast treatment from 2017 to 2021 in a tertiary care centre. We recorded demographic and clinical characteristics at APR baseline and last visit. Furthermore, we recorded the eventual recurrence of primary cancer or the onset of new neoplasms. Paired t-test was used to assess the difference of continuous variables at different follow-ups.

Results

Thirteen patients (sex: female 6/13, 46,15%; mean age (mean ± 63,7 years sd ± 9,9 years)) started Apremilast between 2017 to 2021 in a tertiary care center. We assessed their clinical condition using DAPSA, LEI and PASI score in the baseline and in the last visit. Mean follow-up time was 32,02 ± 18,92 months.

Mean DAPSA at baseline 20,55 ± 9,15 decreased to 16,21 ± 1,73 at last visit. Similarly mean LEI at baseline was 1,23 ± 1,58 and decreased to 0,61 ± 0,35 at last visit, even in absence of statistical significance (p=0,15). Conversely mean PASI at baseline (1,76 ± 2,57) did not show a decrease (1,61 ± 0,93);

Ten patients were still treated with apremilast at last available follow-up. Patient 6 (Table 1) experienced the relapse of Ductal Breast Papilloma. For patient 8, a relapse of primary cancer occurred. Patient 9 had the onset of a new neoplasm. The APR was not discontinued as such malignancies were not considered as treatment associated.

Three patients (4, 6, 10) discontinued APR due to intolerance or lack of efficacy.

Conclusion

APR seems a safe option in PsA patients with a recent history of malignancy or active cancer, improving articular involvement.

Disclosure of Interests

None declared

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