Association of Apremilast With Vascular Inflammation and Cardiometabolic Function in Patients With Psoriasis

作者：Joel M. Gelfand, Daniel B. Shin, April W. Armstrong, Stephen Keith Tyring, Andrew Blauvelt, Scott L. Gottlieb, Benjamin Lockshin, Robert E. Kalb, Robert P. Fitzsimmons, Justin A. Rodante, Philip M. Parel, Grigory A. Manyak, Laurel G. Mendelsohn, Megan H. Noe, Maryte Papadopoulos, Maha N. Syed, Thomas J. Werner, Joy Y. Wan, Martin Peter Playford, Abass A. Alavi, Nehal N. Mehta · 发表于：JAMA Dermatology · 年份：2022 · DOI：10.1001/jamadermatol.2022.3862 · 被引用次数：50 · 研究领域：Psoriasis: Treatment and Pathogenesis、Spondyloarthritis Studies and Treatments、Inflammasome and immune disorders

Importance: Psoriasis is an inflammatory condition associated with metabolic and cardiovascular disease. Apremilast, a phosphodiesterase 4 inhibitor, is commonly used for psoriasis and can cause weight loss. Objective: To determine the association between apremilast and aortic vascular inflammation as assessed by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT), cardiometabolic markers (primary outcomes at week 16), and abdominal fat composition. Design, Setting, and Participants: A single-arm, open-label, interventional, nonrandomized clinical trial in which the imaging and laboratory outcomes were measured by an investigator who was blinded to time was conducted between April 11, 2017, and August 17, 2021, at 7 dermatology sites in the United States. A total of 101 patients with moderate to severe psoriasis were screened, 70 enrolled, 60 completed week 16, and 39 completed week 52. Intervention: Apremilast, 30 mg, twice daily. Main Outcomes and Measures: Aortic vascular inflammation (measured by FDG-PET/CT), 68 cardiometabolic biomarkers, and abdominal fat composition (measured by CT) at week 16 and week 52 compared with baseline. Results: The mean (SD) age of the 70 patients was 47.5 (14.6) years, 54 were male (77.1%), 4 were Black (5.7%), and 58 were White (82.9%). There was no change in aortic vascular inflammation at week 16 (target to background ratio, -0.02; 95% CI, -0.08 to 0.05; P = .61) or week 52 (target to background ratio, -0....