Apremilast Survival and Reasons for Discontinuation in Psoriasis: Five-Year Experience From a Greek Tertiary Care Centre

INTRODUCTION: Drug survival is an indirect measure of efficacy and safety and its post-marketing assessment using real-life data is invaluable. OBJECTIVES: To investigate the survival of apremilast in a cohort of psoriasis patients treated with apremilast in a Greek hospital. METHODS: A retrospective cross-sectional study examined adult psoriasis patients receiving apremilast (March 2016 to January 2021). Primary endpoint was the cumulative survival probability at 52 weeks. Kaplan-Meier analysis was used to calculate survival probability. Cox regression analysis was performed to investigate potential risk factors for apremilast discontinuation. RESULTS: One hundred and two patients (29.4% females) with a mean age of 55.9 years (standard deviation 15.21) were included. Sixty-five patients (63.7%) had discontinued treatment by lock date: 19 (18.6%) due to lack of efficacy, 24 (23.5%) due to loss of efficacy, 15 (14.7%) due to adverse reactions, and 7 (6.9%) due to other reasons. Cumulative survival probability at 52 weeks was 52.1%. Median survival time for all reasons for discontinuation was 58 weeks (95% Confidence Interval 40.02, 75.98). CONCLUSIONS: Approximately half of patients remained on apremilast after 1 year of treatment. Secondary drug failure was the most common reason for discontinuation.