Clinical potential of apremilast in the treatment of psoriatic arthritis.
Clinical potential of apremilast in the treatment of psoriatic arthritis.
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DOI：
10.2147/itt.s40199
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发表时间：
2014
影响因子：
7.2
通讯作者：
Mathieu A
中科院分区：
文献类型：
--
作者：
Cauli A;Porru G;Piga M;Vacca A;Dessole G;Mathieu A
银屑病关节炎（PsA）是一种常见的慢性炎症性疾病，其特征是关节和皮肤受累以及典型的关节外表现。虽然PsA的发病机制仍在研究中，但现有证据表明患者的遗传背景，微生物或环境触发因素以及适应性和获得性免疫系统的不平衡的重要性，导致炎症介质的产生。已经提出了新的治疗方法，其中包括使用细胞内信号和基因转录的调节剂，如PDE 4抑制化合物，其能够调节转录因子如CREB和NF-κB的活性，从而调节炎性介质的合成，导致免疫调节。本文总结了阿普斯特（一种PDE 4抑制剂）的作用机制，以及关于其治疗PsA患者的临床疗效和安全性的现有临床数据。
Psoriatic arthritis (PsA) is a frequent chronic inflammatory disease characterized by joint and skin involvement, and by typical extra-articular manifestations. Although the pathogenesis of PsA is still under investigation, the available evidence suggests the importance of the patient’s genetic background, microbial or environmental triggers, and an imbalance in the adaptive and acquired immune system, resulting in the production of inflammatory mediators. New therapeutic approaches have been proposed, among them the use of modulators of intracellular signals and gene transcription such as PDE4-inhibiting compounds, which are able to modulate the activity of transcription factors such as CREB and NF-κB and therefore the synthesis of inflammatory mediators, resulting in immunoregulation. This paper summarizes the mechanism of action of apremilast, a PDE4 inhibitor, and the clinical data available on its clinical efficacy and safety profile in the treatment of PsA patients.