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Apremilast for oligoarticular PsA: Results from the phase IV FOREMOST trial
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Oligoarticular is a common PsA phenotype, affecting up to 50% of patients, but it is not well studied. FOREMOST (NCT03747939), a phase IV multicenter, randomized controlled trial assessed the safety and efficacy of apremilast, a phosphodiesterase-4 inhibitor, in early oligoarticular PsA (≤4 tender/swollen joints). Results were published by Gossec et al. in Annals of Rheumatic Disease. |
| Key learnings |
| At 16 weeks, more patients on apremilast achieved the primary endpoint of MDA-Joints response compared with placebo (33.9% vs 16.0%, p = 0.0008). |
| Apremilast showed better results for clinical disease activity, patient-reported outcomes (including pain reduction and functional improvement), and skin manifestations at Week 16. |
| The safety profile of apremilast was consistent with known data; the most common adverse events in the apremilast and placebo groups were headaches (7.8% vs 2.9%), nausea (10.8% vs 3.8%), and diarrhea (23% vs 10.6%). |
| The FOREMOST trial suggests apremilast is effective in treating early oligoarticular PsA and may inform appropriate management in these patients. However, additional studies are needed to confirm these findings. |
Abbreviations: MDA, minimal disease activity; PsA, psoriatic arthritis.
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