Depression rate lower with apremilast treatment for psoriasis, psoriatic arthritis
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Depression rates were lower in patients treated with apremilast monotherapy for psoriasis or psoriatic arthritis and higher in those treated with biologics, corticosteroids and non-apremilast combinations, according to a presentation.
“Data comparing the relative risk of depression and/or anxiety between patients exposed to different psoriasis/PsA treatments are needed,” Catherine Vasilakis-Scaramozza, PhD, and colleagues wrote in a poster presented at Maui Derm for Dermatologists. “The objective of this safety study was to estimate rates of treated depression and/or anxiety in patients with psoriasis and/or PsA treated with apremilast compared with users of other systemic treatments.”
Vasilakis-Scaramozza and colleagues analyzed data from 67,189 patients (women, 43.9%; median age, 50.4 years) who had a diagnosis of psoriasis (77%) or psoriatic arthritis with or without psoriasis (23%) and at least one prescription claim for apremilast, conventional disease-modifying antirheumatic drugs (cDMARDs), biologics and/or systemic corticosteroids. The outcome measure of the study was incident cases of anxiety or depression and anti-anxiety or antidepressant prescriptions.
Among the study cohort, 1,125 patients received treatment for depression. Patients treated with apremilast monotherapy had the lowest incidence rate of depression, with higher incidence rate ratios for those treated with biologics (adjusted IRR = 1.8; 95% CI, 1.2-2.7), cDMARDs (aIRR = 1.4; 95% CI, 0.9-2.2), corticosteroids (aIRR = 1.8; 95% CI, 1.2-2.8) and non-apremilast combinations (cDMARDs and corticosteroids: aIRR = 2.4; 95% CI, 1.4-4.2; biologics and cDMARDs or corticosteroids: aIRR = 1.7; 95% CI, 1.1-2.7).
There were no significant differences between apremilast monotherapy and other forms of treatment among the 1,347 patients treated for anxiety.
Among 708 patients treated for anxiety and depression, only combination therapy with apremilast had an elevated IRR (2.6; 95% CI, 1.4-4.8) compared with APR monotherapy.
“In this real-world analysis, [apremilast] monotherapy was not associated with an increased risk of treated anxiety and/or depression,” the researchers wrote. “The results of this study provide reassuring evidence to support the safety of [apremilast] with respect to treated anxiety and/or depression in patients with psoriasis/PsA.”