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Year : 2021  |  Volume : 5  |  Issue : 2  |  Page : 183-186

Apremilast titration: Real-world indian experience

1 Department of Dermatology, Calcutta National Medical College, Kolkata, West Bengal, India
2 Department of Dermatology, Wizderm Skin and Hair Clinic, Kolkata, West Bengal, India
3 Global Medical Affairs, Glenmark Pharmaceuticals Ltd., Mumbai, Maharashtra, India

Correspondence Address:
Dhiraj Dhoot
B D Sawant Marg, Chakala, Andheri (E), Mumbai, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/cdr.cdr_123_20

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Background: Apremilast is recommended to titrate in initial period to reduce adverse effects (AE). But inspite of that, in India; many dermatologists experienced a lot of AE resulting in discontinuation of therapy. As a result, many of them have adapted to titrate the dose in different ways. Objectives: To evaluate the AE profile and rate of discontinuation of apremilast during initial titration in different ways. Materials and Methods: A multicentre, retrospective data analysis was done at 121 dermatology clinics across India in the adult patients diagnosed with chronic plaque psoriasis and prescribed at least one dose of apremilast. Patient characteristics and data were obtained from medical records when available. Results: Out of 582 patients, 175 were prescribed apremilast starter pack in licensed dose (Group 1); 202 were prescribed starter pack in OD dosing (Group 2) for 13 days and 205 were prescribed 2 starter packs in OD dosing (Group 3) for 26 days. 45.14% had AE in Group 1 whereas 36.63% and 30.24% had in Group 2 & 3 respectively. Gastrointestinal upset, headache & nausea were most common. In Group 1, 17.71% of patients discontinued apremilast whereas 16.33% and 10.24% discontinued in Group 2 & 3 respectively. On comparison within group, Group 3 had significant difference over Group 1 (p value <0.05). Conclusion: It is concluded that slower titration of apremilast in initial phase leads to lesser AE profile and hence discontinuation of therapy and thus increasing adherence.

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