Potential risks caused by long-term use of Apremilast (Otelor)

Apremilast (Apremilast), as a PDE4 inhibitor, has good safety in diseases such as psoriasis and psoriatic arthritis. However, long-term use may still bring some potential risks, which requires the attention of patients and doctors. First, long-term use may result in persistent gastrointestinal discomfort, such as nausea, diarrhea, indigestion, and decreased appetite. Some patients have the most obvious symptoms at the beginning of the course of treatment, but a few may experience long-lasting gastrointestinal reactions, leading to weight loss or malabsorption of nutrients. For patients who are underweight or have digestive system diseases, weight changes should be closely monitored during treatment and diet or treatment plans should be adjusted if necessary.

Secondly, long-term use may affect body weight and metabolic status. Clinical studies have shown that some patients experienced weight loss ranging from 2–5 kilograms after taking apremilast for several months, and a few patients even experienced more significant weight loss. While some overweight patients may view this as a "bonus", for underweight or elderly patients, this may become a potential risk, leading to frailty, fatigue and reduced immunity. Doctors generally recommend monitoring body weight monthly during long-term treatment and evaluating the need for dose adjustment or discontinuation if significant weight loss occurs.

In addition, emotional and psychiatric risks are also important aspects to pay attention to during long-term medication use. Apremilast can cause anxiety, depression, or mood swings in a small number of patients, and in rare cases may even trigger suicidal thoughts. Especially patients with a history of depression or anxiety need to be particularly cautious during long-term treatment. It is recommended to conduct regular psychological evaluations, maintain communication with family members, and report any mood changes to the doctor. If necessary, the doctor may adjust the course of treatment, combine psychological support, or use other drugs.

Finally, long-term use of apremilast may also lead to changes in immune regulation Although it is not a strong immunosuppressant, long-term use may slightly affect the immune response, making a small number of patients susceptible to colds, fatigue, or minor infections. In addition, the liver and kidney functions of some patients may experience mild fluctuations during long-term medication, so it is recommended to regularly monitor blood indicators and liver and kidney functions. Through standardized monitoring, timely intervention and individualized medication, most patients can safely use apremilast for a long time and maintain good efficacy.

Reference materials:https://www.drugs.com/