Journal of Clinical Medicine (Jun 2023)
Therapeutic Effects of Apremilast on Enthesitis and Dactylitis in Real Clinical Setting: An Italian Multicenter Study
- Alberto Lo Gullo,
- Andrea Becciolini,
- Simone Parisi,
- Patrizia Del Medico,
- Antonella Farina,
- Elisa Visalli,
- Ylenia Dal Bosco,
- Aldo Biagio Molica Colella,
- Federica Lumetti,
- Rosalba Caccavale,
- Palma Scolieri,
- Romina Andracco,
- Francesco Girelli,
- Elena Bravi,
- Matteo Colina,
- Alessandro Volpe,
- Aurora Ianniello,
- Maria Chiara Ditto,
- Valeria Nucera,
- Veronica Franchina,
- Ilaria Platé,
- Eleonora Di Donato,
- Giorgio Amato,
- Carlo Salvarani,
- Simone Bernardi,
- Gianluca Lucchini,
- Francesco De Lucia,
- Francesco Molica Colella,
- Daniele Santilli,
- Natalia Mansueto,
- Giulio Ferrero,
- Antonio Marchetta,
- Eugenio Arrigoni,
- Rosario Foti,
- Gilda Sandri,
- Vincenzo Bruzzese,
- Marino Paroli,
- Enrico Fusaro,
- Alarico Ariani
Affiliations
- Alberto Lo Gullo
- Unit of Rheumatology, Department of Medicine, ARNAS “Garibaldi”, 95124 Catania, Italy
- Andrea Becciolini
- Internal Medicine and Rheumatology, Department of Medicine, Azienda Ospedaliera Di Parma, 43126 Parma, Italy
- Simone Parisi
- Department of General and Specialistic Medicine, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, 10126 Torino, Italy
- Patrizia Del Medico
- Internal Medicine Unit, Civitanova Marche Hospital, 62012 Civitanova Marche, Italy
- Antonella Farina
- Internal Medicine Unit, Ospedale Augusto Murri—Fermo, 63900 Fermo, Italy
- Elisa Visalli
- Unit of Rheumatology, Ospedale San Marco, 95121 Catania, Italy
- Ylenia Dal Bosco
- Unit of Rheumatology, Ospedale San Marco, 95121 Catania, Italy
- Aldo Biagio Molica Colella
- Unit of Rheumatology, Ospedale Papardo, 98158 Messina, Italy
- Federica Lumetti
- Unit of Rheumatology, Azienda Unità Sanitaria Locale di Modena, 41121 Modena, Italy
- Rosalba Caccavale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00185 Roma, Italy
- Palma Scolieri
- Unit of Internal Medicine and Rheumatology, ASL Roma 1—Presidio Nuovo Regina Margherita, 00153 Roma, Italy
- Romina Andracco
- Asl1 Imperiese, 18100 Sanremo, Italy
- Francesco Girelli
- Internal Medicine Unit, Ospedale “Morgagni–Pierantoni” di Forlì, 47121 Forlì, Italy
- Elena Bravi
- Department of Rheumatology, Ospedale “Guglielmo da Saliceto”, 29121 Piacenza, Italy
- Matteo Colina
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum—Università di Bologna, 40136 Bologna, Italy
- Alessandro Volpe
- Rheumatology Unit, Ospedale Sacro Cuore Don Calabria, 37024 Negrar di Valpolicella, Italy
- Aurora Ianniello
- SL NOVARA, 28100 Novara, Italy
- Maria Chiara Ditto
- Department of General and Specialistic Medicine, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, 10126 Torino, Italy
- Valeria Nucera
- SL NOVARA, 28100 Novara, Italy
- Veronica Franchina
- Unit of Rheumatology, Ospedale Papardo, 98158 Messina, Italy
- Ilaria Platé
- Department of Rheumatology, Ospedale “Guglielmo da Saliceto”, 29121 Piacenza, Italy
- Eleonora Di Donato
- Internal Medicine and Rheumatology, Department of Medicine, Azienda Ospedaliera Di Parma, 43126 Parma, Italy
- Giorgio Amato
- Unit of Rheumatology, Ospedale San Marco, 95121 Catania, Italy
- Carlo Salvarani
- Rheumatology Unit, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Simone Bernardi
- Internal Medicine Unit, Ospedale “Morgagni–Pierantoni” di Forlì, 47121 Forlì, Italy
- Gianluca Lucchini
- Internal Medicine and Rheumatology, Department of Medicine, Azienda Ospedaliera Di Parma, 43126 Parma, Italy
- Francesco De Lucia
- Unit of Rheumatology, Ospedale San Marco, 95121 Catania, Italy
- Francesco Molica Colella
- Unit of Rheumatology, Ospedale Papardo, 98158 Messina, Italy
- Daniele Santilli
- Internal Medicine and Rheumatology, Department of Medicine, Azienda Ospedaliera Di Parma, 43126 Parma, Italy
- Natalia Mansueto
- Asl1 Imperiese, 18100 Sanremo, Italy
- Giulio Ferrero
- Asl1 Imperiese, 18100 Sanremo, Italy
- Antonio Marchetta
- Rheumatology Unit, Ospedale Sacro Cuore Don Calabria, 37024 Negrar di Valpolicella, Italy
- Eugenio Arrigoni
- Department of Rheumatology, Ospedale “Guglielmo da Saliceto”, 29121 Piacenza, Italy
- Rosario Foti
- Unit of Rheumatology, Ospedale San Marco, 95121 Catania, Italy
- Gilda Sandri
- Rheumatology Unit, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Vincenzo Bruzzese
- Unit of Internal Medicine and Rheumatology, ASL Roma 1—Presidio Nuovo Regina Margherita, 00153 Roma, Italy
- Marino Paroli
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00185 Roma, Italy
- Enrico Fusaro
- Department of General and Specialistic Medicine, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, 10126 Torino, Italy
- Alarico Ariani
- Internal Medicine and Rheumatology, Department of Medicine, Azienda Ospedaliera Di Parma, 43126 Parma, Italy
- DOI
- https://doi.org/10.3390/jcm12123892
- Journal volume & issue
-
Vol. 12,
no. 12
p. 3892
Abstract
Introduction: Enthesitis and dactylitis are difficult-to-treat features of psoriatic arthritis (PsA), leading to disability and affecting quality of life. Objective: The aim of this study is to evaluate enthesitis (using the Leed enthesitis index (LEI)) and dactylitis at 6 and 12 months in patients treated with apremilast. Methods: Patients affected by PsA from fifteen Italian rheumatological referral centers were screened. The inclusion criteria were: (a) enthesitis or dactylitisphenotype; (b) treatment with apremilast 30 mg bid. Clinical and treatment history, including PsA disease activity, were recorded. Mann–Whitney and chi-squared tests were used to assess the differences between independent groups, and Wilcoxon matched pairs signed-rank test assessed the differences between dependent samples. A p-value of <0.05 was considered statistically significant. Results: The Eph cohort consisted of 118 patients (median LEI 3); the Dph cohort included 96 patients with a median dactylitis of 1 (IQR 1–2). According to an intention to treat analysis, 25% and 34% of patients with enthesitis achieved remission (i.e., LEI = 0) in T1 and T2. The remission of dactylitis was 47% in T1 and 44% in T2. The per protocol analysis (patients observed for at least 12 months) showed that both dactylitis and LEI significantly improved in T1 (median LEI 1 (IQR 1–3)) and T2 (median LEI 0 (IQR 1–2)). Conclusion: Eph and Dph PsA patients treated with apremilast experienced a significant improvement in enthesitis and dactylitis activity. After 1 year, enthesitis and dactylitis remission was achieved in more than one-third of patients.
Keywords