Date of Award

2019

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

Laura Levy, DHSc, PA-C

Abstract

Objective: The objective of this selective EBM review is to determine whether or not “Is Apremilast 30 mg effective in lowering DLQI scores in patients with plaque psoriasis in 16 weeks of therapy?”

Study Design: Review of three randomized, blind, placebo-controlled clinical trials published between the years 2013 and 2016.

Data Sources: All studies were published in peer-reviewed journals that were located using PubMed database searches.

Outcome Measured: The DLQI is a 10-item questionnaire that assesses the impact of skin disease on health-related quality of life (HRQOL) over the previous week. Scores for each item range from 0 (not at all affected) to 3 (very much affected); total scores range from 0 to 30 and those >10 represent a very large impact on HRQOL. Patients answered questions regarding their physical discomfort and limitations in activities of daily living to psychosocial problems and emotional distress caused by the condition.

Results: All studies showed a statistical significance when comparing Apremilast 30mg BID to a placebo therapy. DLQI scores were decreased by 6.7 points in the study performed by Paul et al., 8.3 points with Reich et al. data, and lastly 4.4 points with the Strand et al. study. (P- values for all studies <0.05)

Conclusion: According to this EBM review Apremilast 30mg is effective in lowering DLQI scores in patients with plaque psoriasis in 16 weeks of therapy. Some studies showed more significant decreases in DLQI scores but overall a patient would experience a lower impact of skin disease on health-related quality of life.

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