AB0415 SIGNIFICANT REDUCTION OF ABDOMINAL FAT WITH APREMILAST TREATMENT IN PATIENTS WITH PSORIATIC ARTHRITIS (2024)

Methods: This multi-center, prospective study included consecutive adults with active PsA in whom apremilast was initiated. Participants received 30 mg administered twice daily after a step-up regimen plan. Assessment of abdominal fat measures was done with Dual Energy X-ray Absorptiometry (DEXA). The values measured comprised android fat mass, arms-legs fat mass, arms-legs lean mass, gynoid fat mass, total body mass, total body fat mass, and truncal fat mass to calculate appendicular lean mass, android to gynoid fat mass ratio, fat mass index, and the percentage of fat distributed to the trunk.

Disease activity was assessed with DAS28-CRP. Measurements were done at baseline, 26, and 52 weeks after initiation of treatment with apremilast. Subsequently, these data were compared using a linear mixed model. The alpha for statistical significance was set at p-values less than 0.05.

Results: Forty four patients (30 females and fourteen males) were included. All patients were included in the intent- to-treat analyses, whereas eighteen (40.8%) of the patients could be included in the, now reported, per protocol analysis. The mean age was 55.6 years (± 11.3) and the median duration of PsA was five years [range 2.0y-12.0y]. At baseline, the participants anthropometric measurements reported a median BMI of 28.2 kg/m² [range 24.2-33.4 kg/m²], a mean hip circumference of 108.0 cm (±14.0 cm), a mean waist circumference of 98.7 cm (±19.1 cm), a mean waist-to-hip ratio of 0.9 (±0.1 cm) and a mean weight of 86,9 kg (±17,1 kg). An overview of the results is presented in Table 1. Following one year of treatment with apremilast significant reductions in total body mass, total body fat mass, truncal fat mass and fat mass index were observed. Similarly, both android fat mass (-0.5 kg; 95% CI [-0.9 – -0.2]; p=0.002) and gynoid fat mass (-0.8 kg; 95% CI [-1.2 – -0.3]; p= <0.001) decreased significantly, alongside with notable reductions in arms-legs fat mass. While the decline in abdominal fat measures continued between weeks 26 and 52, the additional changes in fat mass did not reach statistical significance. Age, sex, diagnosis of diabetes mellitus (DM), and nausea did not demonstrate a significant impact on body mass. Disease activity improved significantly after 52 weeks of treatment with apremilast. Correlation analysis, using a linear mixed model, revealed a significant association between disease activity and changes in body mass parameters (Table 2).