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Do you need to take Otezla forever?

Medically reviewed by Sally Chao, MD. Last updated on Jan 23, 2024.

Official answer

by Drugs.com

Otezla may need to be taken long-term to manage the chronic conditions it is used to treat — psoriasis and psoriatic arthritis. But exactly how long it should be taken can vary because it can depend on factors like personal preference and condition severity.

Symptoms of psoriasis and psoriatic arthritis can come and go unpredictably, and chronic conditions such as these typically require lifelong management. Otezla may help reduce symptoms, prevent flare-ups and even lead to a remission, which is an extended period of time without symptoms.

For some people, Otezla can prevent symptoms of psoriasis or psoriatic arthritis without causing any problematic side effects. In this case, the drug may be continued long-term to keep the condition under control. Long-term studies, ranging from 3 to 5 years, have shown that Otezla is safe for prolonged use.

Other people may not see any (or enough) improvement while they are on Otezla. They may also experience unwanted or severe side effects, and they may want to stop taking the drug or switch to a different treatment.

When you stop taking Otezla:

  • You may remain symptom-free (remission).
  • Your condition may look and feel similar to what it was before treatment (relapse).
  • Your condition may flare up worse than before (rebound).

In clinical trials, people with plaque psoriasis whose condition improved while on Otezla began to lose those improvements around 5 weeks after they stopped taking the medication.

Otezla can also cause side effects that are sometimes severe, including:

  • Diarrhea
  • Nausea or vomiting
  • Weight loss
  • Emerging or worsening depression

If any of these symptoms develop, the dose of Otezla may need to be lowered or even stopped altogether. However, stopping (or even switching) treatments can sometimes cause symptoms to relapse or rebound. It is important not to stop taking Otezla without talking to your doctor first.

Related Questions

References
  1. American Academy of Dermatology. How long will I have to treat my psoriasis? Undated. Available at: https://www.aad.org/public/diseases/psoriasis/treatment/medications/how-long. [Accessed January 20, 2021].
  2. American Academy of Dermatology. Psoriasis treatment: Apremilast. Undated. Available at: https://www.aad.org/public/diseases/psoriasis/treatment/medications/apremilast. [Accessed January 20, 2021].
  3. Kavanaugh A, Gladman DD, Edwards CJ, et al. Long-term experience with apremilast in patients with psoriatic arthritis: 5-year results from a PALACE 1–3 pooled analysis. Arthritis Res Ther. 21, 118 (2019). https://doi.org/10.1186/s13075-019-1901-3.
  4. Crowley J, Thaçi D, Joly P et al. Long-term safety and tolerability of apremilast in patients with psoriasis: Pooled safety analysis for ≥156 weeks from 2 phase 3, randomized, controlled trials (ESTEEM 1 and 2). J Am Acad Dermatol. 2017;77(2):310-317.e1. doi:10.1016/j.jaad.2017.01.052.
  5. U.S. Food & Drug Administration. Otezla (apremilast): Highlights of prescribing information. June 2017. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/205437s006lbl.pdf. [Accessed January 20, 2021].

Read next

Otezla does not cause withdrawal symptoms when stopped, so it may be stopped suddenly, but there have been reports of people experiencing gastrointestinal complaints such as constipation, after they have stopped Otezla. This may be because Otezla tends to help bowels move much better, with some people reporting diarrhea or loose motions while on Otezla, and their stools become a lot harder once they have stopped Otezla. Other symptoms of their condition may also return. For this reason it may be better to reduce the dose of Otezla slowly over a week or two. Continue reading

Otezla is made by Amgen Inc, located in Thousand Oaks, California. Otezla is expensive because it is a brand name drug. The lower-cost generic option called apremilast was approved by the FDA in February 2021, but it is not yet on the U.S. market, possibly due to ongoing patent protection. Continue reading

No, Otezla does not cause weight gain, in fact, it is more likely to cause weight loss. In a pooled analysis of two large trials, ESTEEM 1 and ESTEEM 2, the average change in weight from the start of the trial to week 16 was -1.51 kg, or -3.33 lb for patients receiving Otezla 30mg twice daily. By week 52, approximately 19% of patients had lost more than 5% of their starting weight. Nobody described their weight loss as serious although two patients discontinued treatment because of weight loss. Continue reading

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