POS1556 EFFICACY OF APREMILAST TREATMENT FOR ARTHRITIS IN BEHÇET’S DISEASE

Abstract

BackgroundThe arthritis that occurs in Behcet’s disease (BD) is considered to be an oligoarthritis but one of the intractable symptoms related to quality of life [1]. Apremilast is effective for oral ulcers in BD, but its efficacy against arthritis has not been well established.ObjectivesThis study aims to determine the effect of apremilast treatment on arthritis in BD.MethodsPatients diagnosed with BD disease between January 2011 and June 2022 who had a history of arthritis within the past five years were included in this study. Patients with Behçet’s disease treated with apremilast were compared with those not treated (control group). Frequency of oral and genital ulcers, skin lesions, arthritis, and other typical domains of Behcet’s disease, evaluated every 3 months for 12 months. The number of tender and swollen joints and DAS28 as indicators of arthritis activity and Behçet’s disease activity form (BDCAF) as an indicator of disease activity were investigated retrospectively.ResultsThere were 55 patients with Behçet’s disease available for analysis in this study, 16 of whom were treated with apremilast. There was no clear difference between the two groups for pre-existing BD disease domains. Active lesions at the beginning of the analysis included significantly more oral ulcers and skin pustules in the apremilast group than in the control group, but there was no significant difference in the incidence of arthritis (Table 1). Similarly, there were no significant differences in the number of swollen joints, tender joints, or serum CRP levels between the two groups.The frequency of having arthritis was present in 56.3% of the apremilast group at baseline and decreased in the apremilast group at 3 and 6 months, but remained unchanged in the control group (Figure 1). In the apremilast group, not only did oral ulcers, genital ulcers, and skin pustular lesions improve after 3 and 6 months, but DAS28 and BDCAF also significantly decreased after 3 months (DAS28: p = 0.0010, BDCAF: p = 0.0019).ConclusionApremilast is effective against arthritis as well as skin mucosal lesions in BD and could be one of the treatment strategies for arthritis in BD.Reference[1]Tono T, et al. Clinical features of Behçet’s disease patients with joint symptoms in Japan: A national multicenter study. Mod Rheumatol. 2022;32:1146-1152.Table 1.Characteristics of BD patients.Apremilast TreatmentN=16ControlN=39P valueAge, mean (SD), years46.2 (13.6)40.3 (10.9)0.128Sex, female, number (%)12 (75)28 (71.8)0.807Disease duration, mean (SD), years11.0 (5.7)15.1 (10.7)0.272Active organ involvement, number (%) Oral ulcer16 (100)23 (59.0)0.0002 Genital ulcer5 (31.3)4 (10.3)0.067 Skin lesion11 (68.8)6 (15.4)0.0001 Erythema nodosum1 (6.3)5 (13.2)0.439 Thrombophlebitis1 (6.3)0 (0)0.115 Skin pustules10 (62.5)3 (7.9)<0.0001 Ocular involvement0 (0)1 (2.6)0.404 Epididymis0 (0)1 (2.6)0.172 Gastrointestinal involvement1 (6.3)0 (0)0.113 Arthritis9 (56.3)24 (61.5)0.717 Tender joints (28 joints)1 [0-2.8]1 [0-1]0.523 Tender joints (68 jouints)2 [0-3.8]1 [0-2]0.410 Swollen joints (28 jouints)0 [0-0]0 [0-1]0.117 Swollen joints (66 jouints)0 [0-0]0 [0-1]0.268 CRP, mg/dl0.09 [0.04-0.31]0.09 [0.02-0.21]0.551The statistical analyses were conducted using the chi-squared test or Mann-Whitney U test.#Nonparametric distributions are represented as medians (interquartile range).Figure 1.Effect of apremilast treatment on the rate of specific organ lesionsThe graph summarizes changes in the rate of oral ulcers, genital ulcers, skin lesions, and arthritis in the control group and at baseline (0M), 3 (3M), and 6 (6M) after apremilast treatment. P-values were determined using McNemar test. M, months.Acknowledgements:NIL.Disclosure of InterestsNone Declared.