Key Research Findings

Apremilast has shown promising results as a treatment for psoriasis and psoriatic arthritis. 3 highlights apremilast's approval as a second-line treatment option for these conditions and provides a detailed overview of its gastrointestinal side effects. 16 suggests that apremilast is recommended for patients who have failed traditional oral DMARDs and for whom biologics are contraindicated. Apremilast has also been approved by the FDA for the treatment of oral ulcers associated with Behçet's disease. 14 suggests that apremilast holds potential as a treatment for other inflammatory skin conditions. 20 presents the development of novel nanocrystal-based formulations of apremilast for improved topical delivery, potentially addressing the systemic side effects of oral apremilast. Furthermore, 10 provides an overview of compounds that have reached clinical trials in the past decade, with a focus on those developed for respiratory, skin, and neurological disorders, highlighting apremilast's potential for various inflammatory diseases.

Reasons for Side Effects

Apremilast works by inhibiting an enzyme called PDE4, which is involved in inflammatory responses. PDE4 plays a role in the activation of immune cells, and by inhibiting PDE4, apremilast suppresses immune cell activity and reduces inflammation. 16 explains that apremilast broadly inhibits TNF-α response and leads to a reduction in proinflammatory mediator production.

Common Side Effects

Diarrhea

Diarrhea is the most common side effect associated with apremilast. 3 reports that diarrhea is the most frequent adverse event. It typically occurs within the first month of treatment and is often mild to moderate in severity. 3 , 21 .

Nausea

Nausea is another common side effect of apremilast. 3 lists nausea as one of the most prevalent side effects. Similar to diarrhea, nausea often occurs within the first month of treatment and is usually mild to moderate, resolving naturally over time. 3 , 21 .

Headache

Headache is also a common side effect of apremilast. 3 lists headache as a typical adverse event. Unlike diarrhea and nausea, headache may persist beyond the first month of treatment. 3 , 21 .

Nasopharyngitis

Nasopharyngitis is also reported as a common side effect of apremilast. 4 lists nasopharyngitis as a common side effect of apremilast along with diarrhea, nausea, and headache.

Increased Tearing

Studies have investigated a potential association between apremilast and increased tearing. 18 reports that research has been conducted to evaluate a possible association between apremilast and increased tearing.

Side Effect Management

Diarrhea

Diarrhea caused by apremilast is usually mild to moderate and tends to resolve naturally over time. 3 states that diarrhea is typically mild or moderate in severity and tends to resolve over time with continued dosing and without intervention. If diarrhea is bothersome, consult your doctor. Dietary changes or medications may be used to alleviate symptoms. Dietary recommendations include consuming easily digestible foods and staying well-hydrated. Medications like loperamide, an antidiarrheal, may be prescribed. However, always follow your doctor's instructions carefully. If diarrhea is severe, it may necessitate discontinuing apremilast.

Nausea

Nausea caused by apremilast, similar to diarrhea, is generally mild to moderate and tends to resolve naturally over time. 3 reports that nausea is also usually mild or moderate and tends to resolve over time on its own. If nausea is bothersome, consult your doctor. Dietary changes or medications may be used to alleviate symptoms. Dietary recommendations include consuming easily digestible foods and staying well-hydrated. Medications like ondansetron, an antiemetic, may be prescribed. However, always follow your doctor's instructions carefully. If nausea is severe, it may necessitate discontinuing apremilast.

Headache

Headache caused by apremilast, unlike diarrhea and nausea, may persist beyond the first month of treatment. 3 states that headache, unlike diarrhea and nausea, may persist even after the first month of treatment. If headache is bothersome, consult your doctor. Pain relievers may be used to alleviate symptoms. However, always follow your doctor's instructions carefully. If headache is severe, it may necessitate discontinuing apremilast.

Comparison Across Studies

Similarities Among Studies

These studies suggest that apremilast is effective in treating various inflammatory diseases, including psoriasis, psoriatic arthritis, and Behçet's disease. They also report diarrhea, nausea, and headache as common side effects of apremilast.

Differences Among Studies

These studies vary in terms of the frequency and severity of side effects, treatment efficacy, and study design. For example, 3 specifically investigates gastrointestinal side effects of apremilast, while 16 demonstrates the effectiveness of apremilast in treating psoriatic arthritis.

Implications for Everyday Life

Apremilast is an effective medication for treating inflammatory diseases such as psoriasis, but it carries the risk of side effects. When taking apremilast, be mindful of potential side effects and consult your doctor if they occur. Pay particular attention to gastrointestinal symptoms like diarrhea and nausea, as they may necessitate dietary adjustments or medication to manage.

Limitations of Current Research

Research on apremilast is still in its early stages. As a result, the long-term safety and efficacy of apremilast, its effectiveness in treating various diseases, and the incidence and severity of side effects are not fully understood. Future research should focus on further elucidating the long-term safety and efficacy of apremilast, its effectiveness in treating various diseases, and the incidence and severity of side effects.

Future Research Directions

Future research on apremilast should aim to further clarify its long-term safety and efficacy, its effectiveness in treating various diseases, and the incidence and severity of side effects. Additionally, research should explore combination therapy involving apremilast and investigate individual variations in treatment response.

Conclusion

Apremilast is an effective medication for treating inflammatory diseases like psoriasis, but it carries the risk of side effects. When taking apremilast, be mindful of potential side effects and consult your doctor if they occur. Future research should focus on further elucidating the safety and efficacy of apremilast, its effectiveness in treating various diseases, and the incidence and severity of side effects.