Methotrexate Therapy in Psoriatic Arthritis

Black, Roger L.; O’Brien, William M.; Scott, Edward M.; Auerbach, Robert; Eisen, Arthur Z.; Bunim, Joseph J.

doi:10.1001/jama.1964.03070100037007

Cited by 294 publications

(99 citation statements)

References 7 publications

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“…Most diseasemodifying antirheumatic drugs (DMARDs) used to treat PsA have been employed because of evidence supporting their use in RA; very few controlled studies have demonstrated their efficacy and safety in PsA. In a meta-analysis of PsA clinical studies, only high-dose parenteral methotrexate (MTX; 1-3 mg/kg every 10 days) (13) and sulfasalazine were found to be significantly more efficacious than placebo (14). These agents, as well as other treatment options such as low-dose oral MTX (Յ15 mg/week), cyclosporine, and intramuscular gold, often fail to improve joint and skin symptoms or are poorly tolerated (14)(15)(16).…”

mentioning

confidence: 99%

Efficacy and safety of leflunomide in the treatment of psoriatic arthritis and psoriasis: A multinational, double‐blind, randomized, placebo‐controlled clinical trial

Kaltwasser

Nash

Gladman

et al. 2004

Arthritis & Rheumatism

372

194

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Objective. Current treatment options for psoriatic arthritis (PsA) are limited. Leflunomide, an oral pyrimidine synthesis inhibitor, is highly effective in the treatment of rheumatoid arthritis, and small studies have suggested similar efficacy in PsA. We undertook this double-blind, randomized, placebo-controlled trial to evaluate the efficacy and safety of leflunomide in patients with PsA and psoriasis.Methods. One hundred ninety patients with active PsA and psoriasis (at least 3% skin involvement) were randomized to receive leflunomide (100 mg/day loading dose for 3 days followed by 20 mg/day orally) or placebo for 24 weeks. The primary efficacy end point was the proportion of patients classified as responders by the Psoriatic Arthritis Response Criteria (PsARC). Additional efficacy (joint and skin involvement), safety, and quality-of-life assessments were performed.Results Conclusion. Leflunomide is an effective treatment for PsA and psoriasis, providing a safe and convenient alternative to current therapies.

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mentioning

confidence: 99%

Efficacy and safety of leflunomide in the treatment of psoriatic arthritis and psoriasis: A multinational, double‐blind, randomized, placebo‐controlled clinical trial

Kaltwasser

Nash

Gladman

et al. 2004

Arthritis & Rheumatism

372

194

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“…There is extensive experience with the use of folic acid antagonists (chiefly methotrexate) in the treatment of psoriasis and psoriatic arthritis (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Though it has been common experience that the treatment is effective, side effects have been reported in approximately 20 to 33% of patients (6).…”

Section: Discussionmentioning

confidence: 99%

“…Though it has been common experience that the treatment is effective, side effects have been reported in approximately 20 to 33% of patients (6). Fatalities have been reported (5, 7-9), in 9 patients, 5 of whom had psoriatic arthritis.…”

Section: Discussionmentioning

confidence: 99%

Treatment of psoriatic arthritis with 6‐mercaptopurine

Baum

Hurd

Lewis

et al. 1973

Arthritis & Rheumatism

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Thirteen patients with psoriasis and arthritis were treated with 6-mercaptopurine in dosages ranging from 20 to 150 mg/day (0.36 to 2.4 mg/kg/ day). Eleven of the 13 patients with a diagnosis of psoriatic arthritis showed improvement of the arthritis and psoriasis with minimal side effects. Improvement could be maintained on a dose of about 1.0 mg/kg/ day. The improvement was seen in 3 weeks or less in most cases. Remission after stopping therapy lasted up to 10 months.The use of antimetabolic agents for the treatment of psoriasis is well known. The purine analog, 6-mercaptopurine (6-MP), the pyrimidine analog 6-azauridine triacetate (Azaribine) and the folate antagonist methotrexate, are perhaps the best known agents. Beneficial ef-

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“…Once weekly dose methotrexate (10-25 mg) has been found to be effective [5]. In fulminating arthritis, irreversible crippling deformities can be arrested only by systemic steroids at a dose of less than 7.5 mg prednisolone daily.…”

Section: Journal Of Clinical and Experimental Dermatology Researchmentioning

confidence: 99%

Arthritis Mutilans: A Case Report

Hassan¹

2013

J Clin Exp Dermatol Res

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A fifty year old farmer presented with severe joint pain and swelling in the small joints of hands and feet and a rapidly progressive downhill course over a period of three months. The patient developed joint deformities of hands and feet with digital resorption of the terminal phalanges. Five months after the start of joint deformities, the patient developed well defined erythematosquamous plaques with silvery white scales on the extensor aspect of limbs and scalp. The nails had pitting, discoloration and sub ungual hyperkeratosis. The clinical and histopathological diagnosis was consistent with Psoriasis. A radiograph of hands and feet revealed splaying of the base of the phalanges with tapering of the ends of metacarpals and metatarsals showing 'pencil-in-a cup' deformity. Distal inter phalangeal joints were also involved. A diagnosis of Psoriasis with Arthritis Mutilans was made. The patient was put on injectable Methotrexate and oral steroids.

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Methotrexate Therapy in Psoriatic Arthritis

Cited by 294 publications

References 7 publications

Efficacy and safety of leflunomide in the treatment of psoriatic arthritis and psoriasis: A multinational, double‐blind, randomized, placebo‐controlled clinical trial

Efficacy and safety of leflunomide in the treatment of psoriatic arthritis and psoriasis: A multinational, double‐blind, randomized, placebo‐controlled clinical trial

Treatment of psoriatic arthritis with 6‐mercaptopurine

Arthritis Mutilans: A Case Report

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