FRI0270 APREMILAST IN NON-ULCER MANIFESTATIONS IN BEHçET’S DISEASE. MULTICENTER STUDY OF 32 CASES IN CLINICAL PRACTICE

Background: Behcet’s disease (BD) is a variable vessel vasculitis with a wide and heterogeneous set of signs and symptoms. The inhibitor of phosphodiesterase-4 Apremilast (APR) has demonstrated efficacy in the treatment of oral and/or genital ulcers. Objectives: To assess the efficacy and safety of APR in BD patients with manifestations different from mucocutaneous ulcers. Methods: National multicenter retrospective study on 32 BD patients treated with APR at maintained standard dose of 30 mg twice daily. Results: From a cohort of 49 patients with oral and/or genital ulcers related to BD and refractory to conventional and/or biological treatment, we selected the cases with another clinical manifestation/s (n=32, 23 women/9 men), mean age of 46.35±15.05 years. Non-aphthous manifestations present at apremilast onset were: arthralgia/arthritis (15), folliculitis/pseudofolliculitis (12), asthenia (7), erythema nodosum (3), furunculosis (2), paradoxical psoriasis by TNFi (2), ileitis (2), deep venous thrombosis (2), erythematosus and scaly skin lesions (1), fever (1), eating disorder (1), fibromyalgia (1), unilateral anterior uveitis (1) and neurobehcet (1). APR was used in monotherapy (n=3) or combined (n=29) with oral corticosteroids (20), colchicine (17), methotrexate (5), azathioprine (3), dapsone (1), tocilizumab (1), hydroxychloroquine (1) and/or mesalazine (1). The outcome of the different clinical symptoms is shown in TABLE. The patient with neurobehcet kept stable (paresthesias) during the 6 months of follow-up. The 2 cases of deep venous thrombosis and the case of anterior uveitis resolved with anticoagulants and adjuvant topical treatment, respectively. Furunculosis, folliculitis/pseudofolliculitis and ileitis were the manifestations that improved completely and rapidly. The cases of arthritis experienced improvement, while those with arthromyalgias presented a torpid evolution. Conclusion: Our data show an improvement of the cutaneous follicular and intestinal clinic with APR and a stability of the neurological clinic, while the musculoskeletal manifestations were mostly refractory. References: [1] Davatchi F et al. The International Criteria for Behcet’s Disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria. J Eur Acad Dermatology Venereol. 2014;28(3):338–47. [2] Atienza-Mateo B et al. Anti-interleukin 6 receptor tocilizumab in refractory uveitis associated with Behcet’s disease: multicentre retrospective study. Rheumatology (Oxford). 2018 May 1;57(5):856-864. [3] Santos-Gomez M et al. The effect of biologic therapy different from infliximab or adalimumab in patients with refractory uveitis due to Behcet’s disease: results of a multicentre open-label study. Clin Exp Rheumatol 2016; 34 (6 Suppl 102): S34-40. [4] Gulen Hatemi et al. Apremilast for Behcet’s Syndrome — A Phase 2, Placebo-Controlled Study. N Engl J Med 2015; 372:1510-1518. Disclosure of Interests: Belen Atienza-Mateo: None declared, Jose Luis Martin-Varillas: None declared, J. Loricera: None declared, Vanesa Calvo-Rio: None declared, Jenaro Grana: None declared, Gerard Espinosa: None declared, Clara Moriano: None declared, Trinidad Perez-Sandoval: None declared, Manuel Martin-Martinez: None declared, Elvira Diez Alvarez: None declared, Maria Dolores Garcia-Armario: None declared, Esperanza Martinez: None declared, Ivan Castellvi Consultant for: I received fees less than 5000USD as a consultant for Kern and Actelion, Paid instructor for: I received fees less than 2000USD as a instructor for Boehringer -Ingelheim, Novartis and Gebro, Speakers bureau: ND, Patricia Moya: None declared, Francisca Sivera: None declared, Jaime Calvo Consultant for: Bristol-Myers Squibb, Janssen, Celgene, Sanofi Genzyme, Speakers bureau: Bristol-Myers Squibb, Isabel de la Morena Speakers bureau: Abbvie, Celgene, Pfzier, UCB, Ghebro, Roche, Sanofi, Janssen., Francisco Ortiz-Sanjuan: None declared, Jose Andres Roman-Ivorra: None declared, Ana Perez Gomez: None declared, Sergi Heredia: None declared, Alejandro Olive: None declared, Agueda Prior-Espanol: None declared, Carolina Diez: None declared, Juanjo J Alegre-Sancho: None declared, D Ybanez-Garcia: None declared, Angels Martinez-Ferrer: None declared, J. Narvaez Consultant for: Bristol-Myers Squibb, Ignasi Figueras: None declared, Ana Isabel Turrion : None declared, Susana Romero-Yuste: None declared, Pilar Trenor: None declared, Soledad Ojeda Grant/research support from: AMGEN, Speakers bureau: AMGEN, Santos Castaneda Consultant for: Amgen, BMS, Pfizer, Lilly, MSD, Roche, Sanofi, UCB, D. Prieto-Pena: None declared, Monica Calderon-Goercke: None declared, Lara Sanchez Bilbao: None declared, Inigo Gonzalez-Mazon: None declared, Miguel A. Gonzalez-Gay: None declared, Ricardo Blanco Grant/research support from: Abbvie, MSD and Roche, Consultant for: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen and MSD, Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen and MSD