Adalimumab with Methotrexate vs. Adalimumab Monotherapy in Psoriasis: First-Year Results of a Single-Blind Randomized Controlled Trial

Kraaij, G. E. van der; Busard, C.; Reek, J.M.P.A. van den; Menting, S.P.; Musters, Anne; Hutten, Barbara A.; Rie, Menno A. de; Ouwerkerk, Wouter; Bezooijen, Ji S. van; Prens, Errol P.; Rispens, Theo; Vries, Annick de; Jong, E.M.G.J. de; Kort, W. de; Lambert, Jo; Doorn, Martijn van; Spuls, P.I.

doi:10.1016/j.jid.2022.01.033

Cited by 21 publications

(20 citation statements)

References 36 publications

(43 reference statements)

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“…Matsumoto et al [14] showed that the e cacy of a combination of adalimumab and azathioprine did not vary from that of adalimumab monotherapy in patients with Crohn's disease who had never received either drug. In contrast, in psoriasis, combination therapy of adalimumab and methotrexate displayed a better PASI75 response and lower adalimumab anti-drug antibody than adalimumab monotherapy [15].…”

Section: Discussionmentioning

confidence: 80%

Outcome of adalimumab monotherapy in paediatric non-infectious uveitis

Al-Julandani

Bagri

Tsang

et al. 2022

Preprint

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Background: Adalimumab in combination with other disease-modifying drugs (DMARD) such as methotrexate has a proven efficacy in the management of paediatric non-infectious uveitis. However, many children experience significant intolerance to methotrexate while on this combination, leaving a dilemma for clinicians for choosing the subsequent therapeutic roadmap. Continuation of adalimumab monotherapy might be an alternative feasible option under such settings. This study aims to investigate the efficacy of adalimumab monotherapy in paediatric non-infectious uveitis. Methods: Children with non-infectious uveitis on adalimumab monotherapy (from August 2015 to June 2022) following intolerance to accompanying methotrexate or mycophenolate mofetil were included in this retrospective study. Data was collected at initiation of adalimumab monotherapy and at three monthly intervals until the last visit. Primary outcome was to evaluate disease control on adalimumab monotherapy as determined by the proportion of patients who had less than a 2-step worsening in uveitis (as per SUN score) and no additional systemic immunosuppression during follow-up. Secondary outcome measures were visual outcome, complications and side-effect profile of adalimumab monotherapy. Results: Data was collected for 28 patients (56 eyes). The most common uveitis type and course were anterior and chronic uveitis respectively. Juvenile idiopathic arthritis associated uveitis was the most common underlying diagnosis. During the study period 23 (82, 14%) of the study subjects met the primary outcome. On Kaplan-Meier survival analysis 81.25% (95% CI; 60.6-91.7%) children maintained remission at 12 months of on adalimumab monotherapy. Conclusion: Continuation of adalimumab monotherapy is an effective therapeutic option for the treatment of non-infectious uveitis in children who are intolerant to the combination of adalimumab and methotrexate or mycophenolate.

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Section: Discussionmentioning

confidence: 80%

Outcome of adalimumab monotherapy in paediatric non-infectious uveitis

Al-Julandani

Bagri

Tsang

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…Matsumoto et al [15] showed that the efficacy of a combination of adalimumab and azathioprine did not vary from that of adalimumab monotherapy in patients with Crohn's disease who had never received either drug. In contrast, the combination therapy of adalimumab and methotrexate displayed a trend toward a better PASI 75 response and significantly lower adalimumab anti-drug antibodies than adalimumab monotherapy in psoriasis [16].…”

Section: Discussionmentioning

confidence: 82%

Outcome of adalimumab monotherapy in paediatric non-infectious uveitis

et al. 2023

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Background Adalimumab in combination with other disease-modifying antirheumatic drugs (DMARD) such as methotrexate has a proven efficacy in the management of paediatric non-infectious uveitis. However, many children experience significant intolerance to methotrexate while on this combination, leaving a dilemma for clinicians for choosing the subsequent therapeutic roadmap. Continuation of adalimumab monotherapy might be an alternative feasible option under such settings. This study aims to investigate the efficacy of adalimumab monotherapy in paediatric non-infectious uveitis. Methods Children with non-infectious uveitis on adalimumab monotherapy (from August 2015 to June 2022) following intolerance to accompanying methotrexate or mycophenolate mofetil were included in this retrospective study. Data were collected at the initiation of adalimumab monotherapy and at three monthly intervals until the last visit. The primary outcome was to evaluate disease control on adalimumab monotherapy as determined by the proportion of patients who had less than a 2-step worsening in uveitis (as per SUN score) and no additional systemic immunosuppression during follow-up. Secondary outcome measures were visual outcome, complications and side-effect profile of adalimumab monotherapy. Results Data was collected for 28 patients (56 eyes). The most common uveitis type and course were anterior and chronic uveitis respectively. Juvenile idiopathic arthritis-associated uveitis was the most common underlying diagnosis. During the study period, 23 (82.14%) of the study subjects met the primary outcome. On Kaplan–Meier survival analysis 81.25% (95% CI; 60.6–91.7%) children maintained remission at 12 months on adalimumab monotherapy. Conclusion Continuation of adalimumab monotherapy is an effective therapeutic option for the treatment of non-infectious uveitis in children who are intolerant to the combination of adalimumab and methotrexate or mycophenolate mofetil.

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“…At present, there is more widespread use of therapeutic monitoring in gastroenterology as compared to rheumatology, where it is not a standard practice. The concomitant use of MTX has been shown to lessen development of antidrug antibodies to adalimumab and to improve Psoriasis Area and Severity Index (PASI) scores in patients with PsO and to improve outcomes in patients with RA, but not in patients with PsA (19,20).…”

Section: Treatment Historymentioning

confidence: 99%

Expert Perspective: Management of the Psoriatic Arthritis Patient After Failure of One Tumor Necrosis Factor Inhibitor

Leung

Kavanaugh

Ritchlin

2023

Arthritis & Rheumatology

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The index case, a 36-year-old woman, had psoriasis (PsO) on her scalp, arms, legs, and trunk since age 25 years that was inadequately controlled with topical agents. She has a past medical history of treated hypertension and depression. She is an active smoker. Three years prior to our case evaluation, she developed polyarthritis, inflammatory back pain, and plantar fasciitis. Methotrexate (MTX) was added to her treatment regimen, first administered orally then subcutaneously, but the patient stated she could only tolerate 12.5 mg/week due to gastrointestinal and systemic adverse events. The dose of 12.5 mg/week resulted in minimal benefit. In addition, the patient was recently married and reported that pregnancy was being considered, and therefore treatment with MTX was stopped. She then experienced a flare of PsO and arthritis.Physical examination was notable for the presence of moderate-to-severe PsO (12% affected body surface area [BSA]), 6-7 swollen and tender joints, and evidence of mild erosive changes on hand radiographs. Monotherapy with adalimumab 40 mg every other week was initiated. The patient improved during treatment with adalimumab over 10 weeks, with 60-70% improvement in her clinical symptoms overall, but continued to experience mild residual joint pain and signs of PsO (2-4% BSA). Approximately 3 months ago, she noted profound fatigue, 90 minutes of morning stiffness, and diffuse joint pain. She found it difficult to continue her work in retail and reported feeling frustrated, anxious, and depressed. Her skin PsO also worsened and became more bothersome to her. On physical examination, her blood pressure was 140/90 mm Hg, pulse rate was 72 beats per minute, and body mass index was 35 kg/m 2 . She had psoriasiform plaques on her trunk and extremities (8% BSA). Musculoskeletal examination revealed 6 tender and 4 swollen joints, and she had a Disease Activity Index for PsA (DAPSA) score of 29 (a DAPSA score of >28 represents high disease activity). There were multiple tender entheses, most notably in the plantar fasciae, left Achilles tendon, and the left elbow lateral condyle. Pain was elicited in the right sacroiliac (SI) joint on provocative testing, and also at several locations unassociated with entheses.

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Adalimumab with Methotrexate vs. Adalimumab Monotherapy in Psoriasis: First-Year Results of a Single-Blind Randomized Controlled Trial

Cited by 21 publications

References 36 publications

Outcome of adalimumab monotherapy in paediatric non-infectious uveitis

Outcome of adalimumab monotherapy in paediatric non-infectious uveitis

Outcome of adalimumab monotherapy in paediatric non-infectious uveitis

Expert Perspective: Management of the Psoriatic Arthritis Patient After Failure of One Tumor Necrosis Factor Inhibitor

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