Drug Shows Promise for Early Psoriatic Arthritis

A New Treatment Option

A recent clinical trial indicates that apremilast could offer significant relief for those with early-stage oligoarticular psoriatic arthritis (PsA). Findings from the FOREMOST trial reveal notable reductions in joint swelling and tenderness among patients treated with the drug.

The study, presented at the 2025 Society of Dermatology Physician Assistant (SDPA) annual summer meeting, demonstrated sustained benefits through 48 weeks of apremilast treatment. The research highlights the potential of apremilast as a beneficial therapy option for those with this particular form of PsA.

Kristina Callis Duffin, MD, MS, from the University of Utah, led the research. The focus was on the effectiveness of apremilast in managing weight-bearing joints in early oligo PsA patients.

Trial Details

The FOREMOST trial involved randomizing patients into either the apremilast or placebo groups for 24 weeks. It also included an extension phase where participants received apremilast through week 48.

“FOREMOST is unique as a global randomized controlled trial exclusively studying early oligoarticular PsA,”

—Study Investigators

Post-hoc analysis involving 187 participants with active weight-bearing joints at the trial start found improvements in the Health Assessment Questionnaire-Disability Index (HAQ-DI) with apremilast. Also, patients reported enhancements in the SF-36 and PsAID-12 fatigue scores.

In the US, approximately 30% of people with psoriasis develop PsA, affecting their joints and overall well-being (CDC).

Key Outcomes

The study analyzed outcomes based on baseline body mass index (BMI). The apremilast group showed an average BMI of 30 kg/m2 versus 31 kg/m2 in the placebo group. They also had lower mean swollen and tender joint counts at week 16.

Patients using apremilast reported better physical function, irrespective of their BMI category, by week 16, with those effects maintained during the follow-up.