Methotrexate insufficient for psoriatic arthritis

August 1, 2012

Methotrexate appears to provide no improvement on synovitis in patients with psoriatic arthritis, results of a recent study indicate.

London - Methotrexate appears to provide no improvement on synovitis in patients with psoriatic arthritis, results of a recent study indicate.

Researchers with King’s College, London, analyzed results of a blinded study to clarify the role of methotrexate in psoriatic arthritis, MedPage Today reports. Starting in 2003, investigators enrolled 221 patients who received either a target dosage of 15 mg per week or a matched placebo.

Disease duration was approximately 12 months. More than 80 percent of the participants also were taking nonsteroidal anti-inflammatory drugs.

After six months of treatment, there was no significant effect seen when overall efficacy was assessed on the American College of Rheumatology 20 percent improvement criteria or on the disease activity score in 28 joints. After adjustment for age, sex, duration of disease, and baseline skin score, researchers saw a beneficial effect for the cutaneous component of the disease. But there was a lack of effect on synovitis, so the drug would not be considered “disease-modifying” in psoriatic arthritis.

“We believe a larger trial would not only be impractical but also would be unwarranted in the face of more effective alternatives,” study authors wrote. “We also think that guidelines for treating (psoriatic arthritis) need to be revisited so that the sequencing of conventional drugs before biologics are used is re-evaluated.”

The study was published in the August issue of Rheumatology.

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