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The combination of etanercept and methotrexate increases the effectiveness of treatment in active psoriasis despite inadequate effect of methotrexate therapy
Authors:Zachariae Claus  Mørk Nils-Jørgen  Reunala Timo  Lorentzen Henrik  Falk Edvard  Karvonen Seija-Liisa  Johannesson Anders  Claréus Birgitta  Skov Lone  Mørk Gro  Walker Siân  Qvitzau Susanne
Institution:Department of Dermatology, Copenhagen University Hospital.
Abstract:Many patients with moderate-to-severe plaque psoriasis do not respond adequately to methotrexate monotherapy. This pilot study, with a small patient population, was performed to evaluate the effectiveness and safety of etanercept and methotrexate combination in patients with plaque psoriasis and inadequate response to methotrexate. Outpatients with plaque psoriasis (Psoriasis Area and Severity Index >/= 8 and/or body surface area > 10%), despite methotrexate treatment (>/= 3 months; >/= 7.5 mg/week) were randomized to either etanercept with metho nottrexate tapered and discontinued (n = 28) or etanercept with continuous methotrexate (n = 31). Significantly more patients had a Physicians' Global Assessment of "clear"/"almost clear" in the combination group compared with etanercept/methotrexate taper (66.7 vs. 37.0%, respectively; p = 0.025). Adverse events were similar for both groups, with no cases of tuberculosis, malignancies or opportunistic infections reported. Addition of etanercept to methotrexate achieved significant improvement in psoriasis after 24 weeks.
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