Apremilast for the treatment of Behcet’s syndrome

ABSTRACT

Introduction: Mucocutaneous lesions can be disabling in Behçet’s syndrome patients who experience these lesions frequently and can be an important cause of impaired quality of life. Apremilast may be a safe and effective alternative for the treatment of oral and genital ulcers in Behçet’s syndrome.

Areas covered: This review covers the current data on the efficacy and safety of apremilast in BS patients with mucocutaneous involvement coming from a Phase 2 placebo controlled trial as well as the patient important outcomes reported in the same trial. Observational data in a small number of Behçet’s syndrome patients with different types of involvement, inadequately controlled with other treatment modalities was also reviewed.

Expert opinion: Topical measures and colchicine are traditionally tried as the initial treatment modality for mucocutaneous lesions of Behçet’s syndrome. However these measures may not be sufficient for optimal control of oral and genital ulcers. Immunosuppressive agents such as azathioprine and TNF inhibitors or interferon-alpha are being used for patients with resistant manifestations. However adverse events may limit the use of these agents. Apremilast is a promising agent for the management of BS patients with mucocutaneous lesions due to its efficacy and favourable safety profile.

KEYWORDS:

• Apremilast
• Behçet’s syndrome
• genital ulcers
• oral ulcers
• PDE4 inhibition
• treatment

Declaration of interest

G Hatemi has received research support and/or consulting fees from: Celgene, BMS, MSD, UCB Pharma and Abbvie. Y Yazici has received research support and/or consulting fees from Celgene, Genentech, BMS, Novartis. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded