Evaluation of the actual efficacy of Apremilast (Otelac) in the treatment of psoriatic arthritis

Apremilast (Apremilast) is an oral phosphodiesterase 4 (PDE4) inhibitor, mainly used to treat moderate to severe psoriasis and psoriatic arthritis (PsA). Its mechanism of action is to inhibit PDE4 activity and increase intracellular cAMP levels, thereby regulating the expression of inflammatory factors and reducing pro-inflammatory cytokines such as TNF-α, IL-17 and IL-23 levels, while increasing levels of anti-inflammatory factors, thereby reducing arthritis symptoms and skin lesions. Clinical studies have shown that apremilast can significantly relieve joint pain, swelling and morning stiffness in patients with psoriatic arthritis, and improve their quality of life.

In terms of actual clinical efficacy, multiple trials and real-world studies have shown that apremilast can improve joint symptoms and motor function. After taking the medicine for several weeks, most patients can observe a reduction in joint pain and improvement in swelling, an increase in joint mobility, and a shortening of morning stiffness. For patients with moderate to mild symptoms, the symptom improvement effect is more obvious, and some patients even reach clinical remission standards within a few months. At the same time, apremilast also has a certain improvement effect on skin lesions, and is especially effective in controlling psoriasis plaques on the palms and soles or small areas.

Long-term medication observation shows that the efficacy of apremilast is relatively stable and well tolerated. After half a year to one year of continuous medication, most patients can still maintain improvement in joint symptoms. At the same time, side effects are relatively mild. Commonly seen are diarrhea, nausea, headache or upper respiratory tract infection, etc. Most of them are mild to moderate and can be alleviated through symptomatic treatment or short-term drug withdrawal. Compared with biological agents, oral administration of apremilast is more convenient and does not require injection or frequent monitoring of blood concentration, making it easier to maintain treatment in the long term.

Taken together, apremilast has good clinical efficacy and safety in patients with psoriatic arthritis. It can effectively improve arthritis symptoms, improve quality of life, and maintain stable efficacy during long-term medication. For patients with moderate to severe disease, especially those who cannot tolerate or are not candidates for biologics, apremilast provides a convenient, long-term management option. However, patients still need to follow the doctor's advice during medication and regularly review joint function and blood indicators so that the treatment plan can be adjusted in a timely manner to achieve the best effect.

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