Otezla (apremilast) is a medication approved by the Food and Drug Administration for treating plaque psoriasis.
In a recent study, scientists say they found the drug may also help people with psoriasis reduce body fat, potentially improving their cardiovascular health. Researchers at the Perelman School of Medicine at the University of Pennsylvania measured changes in 70 study participants in inflammation around the aorta as well as looking at changes in body composition and examining 68 cardiometabolic biomarkers.
A biomarker is a molecule found in blood or other bodily fluids or tissues that signals normal and abnormal processes or a condition or disease, according to the National Institutes of Health.
The Penn researchers reported that taking Otezla:
- Did not bring about meaningful changes in inflammation around the aorta
- Generated variable but generally positive decreases in cardiometabolic biomarkers
- Influenced an average of 5% to 6% reduction in subcutaneous and visceral fat. The reduced fat appeared about four months after treatment began and continued throughout the study
“The study’s most provocative findings are that the drug decreased subcutaneous and visceral fat,” said Dr. Joel M. Gelfand, MSCE, the lead author of the study and vice chair of clinical research as well as medical director of the Penn Medicine Dermatology Clinical Studies Unit and director of the Psoriasis and Phototherapy Treatment Center, in a press statement. “We’re trying to untangle cardiovascular disease for this population so they can achieve better outcomes in the skin and joints, and live longer healthier lives,” he noted.
Subcutaneous fat is stored just under the skin or is found in the arms and legs. Visceral fat wraps around the abdominal organs, such as the liver, stomach, and intestines. Men with a waist 40 inches or larger and women with a waist of 35 inches or larger are at risk of health problems from visceral fat, according to the Harvard TH Chan School of Public Health.
Some of the health problems associated with visceral fat include:
- Insulin resistance and diabetes
- High blood pressure
- Heart attack and heart disease
- Stroke
- Breast cancer
- Colorectal cancer
- Alzheimer’s disease
“Apremilast has been associated with mild weight loss in the past and this study supported this finding,” said Dr. Jessica Kaffenberger, a dermatologist specializing in psoriasis at The Ohio State University Wexner Medical Center. “Unfortunately, it did not show a decrease in aortic inflammation,” said Kaffenberger. “However, it is possible that the decrease in adipose could provide cardioprotective effects. We don’t know that for sure based on this data so it would be good to see data over a longer period.”
Gelfand also worked on a 2006 study that found people with psoriasis, especially those with severe disease, may have an increased risk of death from cardiovascular disease compared to the general population. The researchers of the current study believe larger controlled studies are needed. In the meantime, they urge doctors to screen for cardiovascular disease in people with psoriasis.
“I don’t think this is an issue,” says Kaffenberger. “There is a negative finding that the drug did not decrease aortic vascular inflammation, so I don’t think the funding sways anything.”
Parvathy Sukumaran 
