The oral phosphodiesterase 4 inhibitor apremilast (Otezla) is indicated for the treatment of oral ulcers associated with Behçet's disease in some countries, including the USA (where it is the first agent approved for the disease) and Japan. In phase 2 and 3 trials in adults with this chronic and debilitating disorder, 12 weeks of treatment with apremilast 30 mg twice daily reduced the number and pain of oral ulcers and disease activity relative to placebo, with these clinical benefits being accompanied by improvements in health-related quality of life (HR-QOL). Benefits of apremilast were seen regardless of baseline patient/disease characteristics and in Japanese patients, and were sustained over up to 64 weeks of treatment. Apremilast was generally well tolerated, with gastrointestinal adverse events being among the most common tolerability issues. Emerging real-world data also support the drug's use in this setting. Thus, for patients with oral ulcers associated with Behçet's disease, apremilast provides an effective and generally well tolerated approved treatment option.
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