The European Congress of Rheumatology (EULAR) took place from May 31 – June 3, 2023. During the Congress, experts in rheumatology came together to discuss research, new guidelines, and opportunities to combat rheumatic and musculoskeletal diseases. Two presentations explored the use of Otezla (apremilast) in psoriatic arthritis (PsA). In the first, the Amgen team shared data from the Phase 4 MOSAIC trial that suggests that the medicine reduces inflammation as seen on imaging. The second presentation focused on an exploratory study regarding Otezla’s effects on cardiometabolic health.
What is Psoriatic Arthritis (PsA)?
Before we dive in, let’s do a brief overview of what psoriatic arthritis is. This chronic inflammatory arthritis occurs in some people with psoriasis, an immune-mediated skin condition that causes raised, scaly, flaky patches of skin. Typically, people develop psoriasis first and later learn that they have PsA; however, in rarer cases, the joint manifestations may happen first. PsA can affect any joint in your body, such as the knees, shoulders, and pelvis. While the exact cause of PsA is unknown, 40% of people have a family history, suggesting some genetic predisposition. Symptoms usually appear between 30-50 years old and can include:
- Joint stiffness and inflammation
- Red skin patches with silvery scales
- Tendon tenderness, pain, and swelling
- Extremely swollen fingers and toes
- Fatigue
- Back pain
- Reduced range of motion
- Pitted nails
- Uveitis or conjunctivitis
The Efficacy of Otezla
As reported by Healio, the Phase 4 trial sought to identify how effective Otezla was in reducing inflammation. Inflammation was scored using the psoriatic arthritis MRI score (PsAMRIS) as seen on magnetic resonance imaging (MRIs). 98 participants enrolled.
To begin, participants in the study underwent an MRI on their hand. This was repeated at 24 weeks (5.5 months) and 48 weeks (11 months). The researchers wanted to see whether Otezla helped to improve issues such as:
- Synovitis: when the synovial membrane within joints becomes swollen and painful
- Tenosynovitis: when the tendon sheath becomes swollen, especially where muscle meets bone
- Hand bone marrow edema: when fluid accumulates in your bone marrow
Otezla prevented bone damage and stopped PsA from progressing. It also significantly reduced inflammation, providing a higher quality-of-life to patients.
In the second study, an exploratory analysis, the researchers sought to understand how Otezla influenced body mass index, HbA1c levels, and low-density and high-density lipoprotein. 781 participants enrolled. Researchers examined data from one full year of participants taking Otezla. They found that people on Otezla were better able to reduce their weight (and thus body mass index). HbA1c, low-density lipoprotein, and high-density lipoprotein levels were also normalized in a significant number of patients.
