Early Oligoarticular PsA Disease Burden, Joint Involvement

Patients with early oligoarticular psoriatic arthritis (PsA) have high disease burdens and impaired quality of life, according to a study recently presented at American College of Rheumatology Convergence 2022.

Included in this analysis were 220 participants of the ongoing FOREMOST study who met the classification criteria for psoriatic arthritis and had at least one but no more than 4 tender and swollen joints involved at screening. All patients had a disease duration of less than one year.

The mean Physician Global Assessment of Disease Activity score was 43.9, while the Patient score was 51.3. The mean patient pain assessment score was 50.7 and there was an average PsA Impact of Disease domain score of 4.7. The mean Health Assessment Questionnaire Disability functional assessment score was 1.0, of which 25.5% of patients had scores of 0.5.

The swollen or tender joints involved were mostly small joints, with approximately 48% of joint involvement in the finger proximal interphalangeal joints and > 2% in temporomandibular and clavicular joints.

Also included among the small joint size were:

  • Metacarpophalangeal
  • Metatarsophalangeal
  • Distal interphalangeal
  • Hand carpometacarpal
  • Mid-tarsal

Intermediate size joints included wrist elbow, ankle, temporomandibular, acromioclavicular, and sternoclavicular. Large size joints included should, hip, and knee. Of the total participants, 59% had joint involvement of more than one size.

Dactylitis (14.5%), enthesitis (32.7%), nail involvement (67.3%), and skin disease (47.7% with a body surface area of 3%) were among the other manifestations observed at baseline.

“In FOREMOST, despite few joints involved, patients with early oligoarticular PsA experienced high disease burden and impaired quality of life,” researchers concluded. “Small joint involvement, although less commonly expected in oligoarticular PsA, wass the most frequently observed pattern.”


—Leigh Precopio



Gladman D, Coates L, Gossec L, et al. Characterizationn of joint distribution and disease burden in patients with early oligoarticular psoriatic arthritis: results from the ongoing FOREMOST study. Paper presented at: American College of Rheumatology Convergence 2022; November 10-14, 2022; Philadelphia, PA. Accessed November 2, 2022.