From the Guidelines
The standard dosing schedule for Otezla (apremilast) in psoriatic arthritis begins with a 5-day titration period to minimize gastrointestinal side effects, followed by a maintenance dose of 30 mg twice daily. According to the joint American Academy of Dermatology-National Psoriasis Foundation guidelines of care for the management of psoriasis with systemic nonbiologic therapies 1, the dosage titration schedule is as follows:
- Day 1: 10 mg (AM)
- Day 2: 10 mg (AM & PM)
- Day 3: 10 mg (AM); 20 mg (PM)
- Day 4: 20 mg (AM & PM)
- Day 5: 20 mg (AM); 30 mg (PM)
- Day 6 onward: 30 mg (AM & PM). It is essential to note that dose adjustments may be needed for patients with severe renal impairment (creatinine clearance less than 30 mL/min), and the medication should be reduced to 30 mg once daily in such cases 1. Common side effects include diarrhea, nausea, upper respiratory tract infections, and headache, which typically improve over time 1. Patients should be monitored for weight loss and depression, as these can occur with Otezla treatment 1.
From the Research
Otezla Dosing Schedule for Psoriatic Arthritis
- The recommended dosing schedule for Otezla (apremilast) in the treatment of psoriatic arthritis is 30 mg twice daily 2, 3.
- This dosing schedule has been shown to improve signs and symptoms in both disease-modifying antirheumatic drug (DMARD)-naïve and DMARD-experienced patients with active psoriatic arthritis 2.
- Apremilast has been found to have an early onset of efficacy in patients with active psoriatic arthritis, with significant improvements in symptoms seen as early as week 2 2.
- The efficacy of apremilast in the treatment of psoriatic arthritis has been sustained for up to 208 weeks 2.
Key Benefits of Otezla in Psoriatic Arthritis
- Improves signs and symptoms of psoriatic arthritis, including enthesitis, dactylitis, physical function, and fatigue 2, 3.
- Has an early onset of efficacy, with significant improvements in symptoms seen as early as week 2 2.
- Is generally well tolerated, with no laboratory monitoring required 2.
- Has been approved by both the United States FDA and European Medicines Agency for the treatment of psoriatic arthritis 3.