RESUMO
We present a series of general and specific recommendations based on pathophysiologic considerations for managing the most common adverse effects of apremilast that lead to treatment discontinuation: diarrhea, nausea, and headache. The recommendations are based on a review of the literature and the experience of a multidisciplinary team of 14 experts including dermatologists, rheumatologists, neurologists, gastroenterologists, pharmacists, and nurses. We propose a series of simple algorithms that include clinical actions and suggestions for pharmacologic treatment. The adverse effects of apremilast can be managed from a multidisciplinary approach. The purpose of optimizing management is to bring clinical benefits to patients.
Assuntos
Diarreia/induzido quimicamente , Cefaleia/induzido quimicamente , Náusea/induzido quimicamente , Inibidores da Fosfodiesterase 4/efeitos adversos , Talidomida/análogos & derivados , Terapia Combinada , Diarreia/dietoterapia , Diarreia/tratamento farmacológico , Diarreia/fisiopatologia , Gerenciamento Clínico , Cefaleia/tratamento farmacológico , Cefaleia/fisiopatologia , Cefaleia/prevenção & controle , Humanos , Náusea/dietoterapia , Náusea/tratamento farmacológico , Náusea/fisiopatologia , Equipe de Assistência ao Paciente , Inibidores da Fosfodiesterase 4/uso terapêutico , Guias de Prática Clínica como Assunto , Psoríase/tratamento farmacológico , Talidomida/efeitos adversos , Talidomida/uso terapêuticoRESUMO
Semantic variant primary progressive aphasia (svPPA) is a clinical syndrome included in the frontotemporal dementia (FTD) spectrum. Unlike other forms of FTD, it is sporadic in the majority of cases and not commonly associated with motor neuron disease (MND). We describe a case of svPPA associated with MND in the same family, due to a mutation of the transactive response DNA binding protein (TARDBP) gene, and review the literature.