Apremilast for oral ulcers in Behçet syndrome (November 2019)

 

재발성 구강궤양에서 apremilast는 콜히친 대안으로 사용될 수 있습니다.

 

Oral aphthae와 genital ulcers의 경우 초기 치료는 topical corticosteroids입니다.

 

Recurrent oral ulcers와 genital ulcers 예방을 위해서는 경구 스테로이드보다는 콜히친 하루 1-2 mg을 2-3회 분할하여 복용합니다.

 

Apremilast는 recurrent oral ulcers 환자에서 glucocorticoid-sparing agent로서 콜히친의 합리적인 대안입니다.

 

콜히친과 apremilast의 치료 반응을 위해 약 12주를 기다립니다. Topical corticosteroids, 콜히친, apremilast에도 재발하거나 다발 병변인 경우에는 시작 용량 프레드니손 15 mg/day를 추가합니다.

 

REF. UpToDate 2020.04.12

 

 

What's New

Apremilast for oral ulcers in Behçet syndrome (November 2019)

 

Most patients with Behçet syndrome manifest painful and recurrent oral aphthous ulcers.A trial of 207 patients with Behçet syndrome and active oral ulcers found thatapremilast, an oral phosphodiesterase 4 inhibitor, resulted in a greater reduction in the number of oral ulcers after 12 weeks, with continuation of this benefit out to 28 weeks. Apremilast also improved pain scores and approximately doubled the number of patients with complete resolution of ulcers compared with placebo. Apremilast was associated with more adverse events, includingdiarrhea, nausea, and headache.Althoughcolchicinehas traditionally been used for prevention of recurrent oral ulcers and is still generally favored based on rapid onset, low cost, and tolerability, apremilast is another option.