Long-term survival of methotrexate in psoriatic arthritis

Abstract

Objective. The purpose of this study was to evaluate the long-term survival rate of Methotrexate (MTX) in the peripheral joint involvement of psoriatic arthritis (PsA) in a setting of everyday clinical practice. Methods. This was an observational restrospective study performed using the data from a dermatological-rheumatological PsA clinic. All of the patients evaluated at this clinic from March 1997 to December 2007 who were started on MTX alone, had a three-year follow-up time or had discontinued the therapy were included into the survey. Results. Of the 174 evaluable patients, 104 (59.8%) were still taking MTX after three years of treament. The reasons of therapy discontinuation in the remaining 70 (40.2%) patients were: 34 (19.5%) lost-to-follow-up, 18 (10.3%) adverse events, 14 (8%) inefficacies, and 4 (2.3%) deaths (none related to the therapy). MTX was effective in controlling joint inflammation but not in preventing their deterioration. Overall, adverse events were recorded in 43 patients (36.4% of the 114 patients with a three-year follow-up). No serious side effect occurred in the study population. Conclusions. The results of this study showed that, in a setting of clinical pratice, MTX had a good three-year performance in patients with peripheral PsA. Almost 60% of them were still taking this drug at the end of the study period and the toxicity was more than acceptable. In our opinion, MTX might be considered the non-biological DMARD of choice for the treatment of this condition. However it should be used earlier and at higher doses

Methotrexate and leflunomide survival in patients with psoriatic arthritis

“…Conversely, Dalkilic et al described a lower GI intolerance to MTX, corresponding to 28.6% [17]. The Italian cohort only reported 10% of adverse events and patients had a good tolerance to MTX [15]. Comparisons between these cohort is difficult due, among other reasons, to loss of follow up, the variable number of patients and the median MTX dose used included in each study.…”

Use of methotrexate in the treatment of psoriasis and psoriatic arthritis

“…Дозу препарата увеличивали постепенно, каждые 4 нед, с 7,5 до 25 мг/нед к 5-му месяцу терапии, применение глюкокортикоидов (ГК) внутрь не допускалось, кроме однократного внутрисуставного введения ГК в течение всего срока наблюдения. Авторы делают вывод о недостаточной эффективности МТ в таблетках в низкой дозе 15 мг/нед [45]. Несмотря на небольшой объем данных, исследователи предполагают, что еженедельная доза >15 мг является своего рода пороговой, на фоне которой вероятность проявления клинического эффекта МТ повышается.…”

Real-life experience of using conventional disease-modifying anti-rheumatic drugs (DMARDs) in psoriatic arthritis (PsA). Retrospective analysis of the efficacy of methotrexate, sulfasalazine, and leflunomide in PsA in comparison to spondyloarthritides other than PsA and literature review of the use of conventional DMARDs in PsA

“…Ricci et al (37) in their observational retrospective analysis demonstrated that in a setting of clinical practice MTX had good performance over 3 years in patients with peripheral PsA. Almost 60% of them were still taking this drug at the end of the study period, and toxicity was more than acceptable.…”