Apremilast trims fat mass, reducing CV events in PsA patients

Treatment with apremilast results in fat mass reduction among patients with psoriatic arthritis (PsA), indicating positive cardiovascular (CV) and metabolic effects, which may lower the risk of CV events, a recent study has shown.

Forty-four patients (mean age 56 years, median BMI 28 kg/m²) were enrolled in this prospective cohort study. Of these, 17 completed treatment, while 27 discontinued due to ineffectiveness or side effects.

Patients who competed treatment at 1 year showed significant reductions in several body mass measures, including total fat (–7.4 kg; p=0.005) and android fat (–1.1 kg; p=0.002). Lean mass remained stable, while blood pressure (BP) decreased slightly. On the other hand, no change occurred in lipids, intima-media thickness, and glucose levels.

Improvements were noted in disease activity, as shown by a significant reduction (–0.6; p=0.01) in Disease Activity Score in 28 joints (DAS28) based on C-reactive protein (CRP). Android fat showed the strongest association with disease activity reduction (r, 0.31; p=0.004).

In this longitudinal, nonrandomized, multicentre trial, the investigators identified adults with active PsA initiating apremilast 30 mg twice daily after a step-up regimen. They followed the participants for 12 months and carried out measurements at baseline and at weeks 26 and 52. Dual-energy x-ray absorptiometry was used to assess body composition, the primary outcome.

Other outcomes assessed included disease activity (DAS28-CRP), BP, lipids, intima-media thickness, and glucose. Mixed models adjusted for relevant covariates were used for statistical analysis.