Multidisciplinary Management of the Adverse Effects of Apremilast

Actas Dermosifiliogr (Engl Ed). 2021 Feb;112(2):134-141. doi: 10.1016/j.ad.2020.08.007. Epub 2020 Sep 7.
[Article in English, Spanish]

Abstract

We present a series of general and specific recommendations based on pathophysiologic considerations for managing the most common adverse effects of apremilast that lead to treatment discontinuation: diarrhea, nausea, and headache. The recommendations are based on a review of the literature and the experience of a multidisciplinary team of 14 experts including dermatologists, rheumatologists, neurologists, gastroenterologists, pharmacists, and nurses. We propose a series of simple algorithms that include clinical actions and suggestions for pharmacologic treatment. The adverse effects of apremilast can be managed from a multidisciplinary approach. The purpose of optimizing management is to bring clinical benefits to patients.

Keywords: Adverse effects; Apremilast; Cefalea; Diarrea; Diarrhea; Efectos adversos; Headache; Nausea; Náuseas; Psoriasis.

MeSH terms

  • Combined Modality Therapy
  • Diarrhea / chemically induced*
  • Diarrhea / diet therapy
  • Diarrhea / drug therapy
  • Diarrhea / physiopathology
  • Disease Management
  • Headache / chemically induced*
  • Headache / drug therapy
  • Headache / physiopathology
  • Headache / prevention & control
  • Humans
  • Nausea / chemically induced*
  • Nausea / diet therapy
  • Nausea / drug therapy
  • Nausea / physiopathology
  • Patient Care Team
  • Phosphodiesterase 4 Inhibitors / adverse effects*
  • Phosphodiesterase 4 Inhibitors / therapeutic use
  • Practice Guidelines as Topic
  • Psoriasis / drug therapy
  • Thalidomide / adverse effects
  • Thalidomide / analogs & derivatives*
  • Thalidomide / therapeutic use

Substances

  • Phosphodiesterase 4 Inhibitors
  • Thalidomide
  • apremilast