A psoriasis drug shows promise in helping patients reduce drinking

A drug used for treating psoriasis was found to reduce drinking in patients and may be useful in treating alcohol-use disorders (AUDs). Apremilast is a selective phosphodiesterase type 4 (PDE4) inhibitor—which has now been shown by a novel bioinformatics approach to be associated with alcohol and nicotine dependence. It was chosen for study by researchers as a possible treatment for AUD in a proof-of-concept study. As well, the drug has a low incidence of adverse events and a good safety profile, they wrote in the Journal of Clinical Investigation. The study encompassed testing in multiple animal strains and models, as well as a human phase IIa study. The final part of the study was a double-blind, placebo controlled clinical proof-of-concept study to determine the effects of apremilast in non-treatment seeking individuals with AUD. The study noted that recent evidence suggests that increased expression of PDE4 subtypes is linked to human AUD. In one of the animal portions of the study, the researchers found that binge-drinking increased the expression of two PDE4 subtypes in a part of the brain integral to alcohol drinking. Read: Are you patients hopping on the wagon? Canadian beer, wine sales see unusually large drop The phase IIa study included paid participants aged 18 to 65 years of age—24 women and 27 men with a mean age of 41.2 years. They all had with moderately severe AUD. The subjects had been drinking heavily for an average of 12.3 years. A total of 26 of the participants were randomized to the treatment and 25 were in the placebo group. Pre-treatment drinks per day, rate of heavy drinking, and number of DSM 5 symptoms did not differ between the groups. It was found that over an 11-day period, apremilast significantly reduced the number of drinks per day relative to placebo, and was also associated with fewer heavy drinking days. Calculations showed that the drop in the number of drinks from day one to day 11 of was 2.74 drinks per day in the apremilast group and 0.48 for placebo, the study said. A two-week post-treatment follow-up showed no evidence of rebound. As far as adverse events went the apremilast group was about two or more times more likely to experience diarrhea, nausea, abdominal pain and somnolence. The researchers concluded that “these findings suggest apremilast reduces both the daily quantity of alcohol consumed as well as the frequency of heavy drinking episodes.”

A psoriasis drug shows promise in helping patients reduce drinking

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