Spondyloarthritis & psoriatic arthritis
Treatment of early oligoarticular psoriatic arthritis with apremilast: primary outcomes at week 16 from the FOREMOST randomised controlled trial
Authors' conclusion
FOREMOST is the first randomised controlled trial designed for early oligoarticular PsA and showed apremilast improves clinical and patient-reported outcomes.
Study context
- Population
- Patients with early (symptom duration ≤5 years) oligoarticular psoriatic arthritis (PsA) (>1 but ≤4 swollen and >1 but ≤4 tender joints; 2–8 total active joints)randomised
- Participants
- 308 patients
- Comparison
- Apremilast 30 mg twice daily vs placebo for 24 weeks
- Apremilastn = 203
- Placebon = 105reference
- Primary endpoint
- Proportion achieving MDA-Joints (≤1 swollen and ≤1 tender joint) based on sentinel joints (affected at baseline), non-responder imputation plus multiple imputations
- Follow-up
- Week 16
Methodological detailsphase 4, multicentre, double-blind, placebo-controlled, early escape at week 16
- Phase 4
- Multicentre
- Double-blind
- Placebo-controlled
- Early escape at week 16
Primary result
As reported in the abstract
MDA-Joints, sentinel joints
P = 0.0008
Further findings
MDA-Joints, all joints (exploratory) · week 16
nominal p=0.0028
Patient-reported outcomes, clinical disease activity and skin involvement
- Greater improvements with apremilast vs placebo
Original publication
Treatment of early oligoarticular psoriatic arthritis with apremilast: primary outcomes at week 16 from the FOREMOST randomised controlled trial. Ann Rheum Dis. Published 21 October 2024. doi:10.
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