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Apremilast — SCE Dermatology MCQ

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HardDermatopharmacologyApremilastSCE Dermatology

A patient taking apremilast develops persistent severe diarrhoea and clinically important unintentional weight loss. What is the most appropriate medicine-related response?

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Correct answer: D — Interrupt apremilast and assess hydration, weight loss and alternative causes

The best answer is “Interrupt apremilast and assess hydration, weight loss and alternative causes”. Gastrointestinal adverse effects and weight loss are recognised with apremilast. Persistent severe symptoms warrant clinical review, assessment for dehydration or alternative causes, and consideration of interruption or discontinuation rather than automatic continuation. The alternatives “Continue the current dose with rehydration and close weight monitoring”, “Reduce to once-daily dosing while investigating other gastrointestinal causes”, “Use short-term antidiarrhoeal treatment while maintaining the current dose”, “Change to another systemic therapy after completing its baseline screening” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: NICE CG153 psoriasis recommendations: https://www.nice.org.uk/guidance/cg153/chapter/Recommendations