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AMAP also undergoes extensive CYP-mediated bioactivation to chemically reactive species in vitro and in vivo (Rashed and Nelson 1989

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Although its efficacy is lower than methotrexate and cyclosporine, apremilasts favorable safety profile, particularly its low hepatotoxicity risk, makes it a valuable option for patients who require long-term systemic therapy and cannot tolerate immunosuppressants (Papp et al