TY  - JOUR
A1  - Behrens, Frank
A1  - Köhm, Michaela
A1  - Schwaneck, Eva Christina
A1  - Schmalzing, Marc
A1  - Wittig, Bianca Maria
A1  - Gnann, Holger
A1  - Greger, Gerd
A1  - Tony, Hans-Peter
A1  - Burkhardt, Harald
T1  - Addition or removal of concomitant methotrexate alters adalimumab effectiveness in rheumatoid arthritis but not psoriatic arthritis
T2  - Scandinavian journal of rheumatology
N2  - Objective: Randomized trials have shown that concomitant methotrexate (MTX) augments the effectiveness of tumour necrosis factor (TNF) inhibitors in rheumatoid arthritis (RA), but its benefit in psoriatic arthritis (PsA) has not been demonstrated. The goal of this study was to examine whether the impact of concomitant MTX on therapeutic outcomes in patients with PsA was similar to its effects in RA.

Methods: We used data from highly comparable and concurrent observational studies of patients with PsA (N = 1424) or RA (N = 3148) who initiated adalimumab therapy during routine clinical care. The 28-joint Disease Activity Score (DAS28) and patient-reported pain scores were evaluated in patients who received 24 months of continuous treatment with adalimumab monotherapy or adalimumab + MTX and in patients who initiated or stopped concomitant MTX during ongoing adalimumab therapy.

Results: Twenty-four months of continuous treatment with adalimumab + MTX was superior to adalimumab monotherapy in RA patients, while no significant difference was observed in patients with PsA. RA patients who added MTX during the study showed significant individual improvements in DAS28 and pain scores at 6 months after the change in therapy, while those who removed MTX had slight increases in disease activity. In contrast, in patients with PsA, neither initiation nor removal of MTX during continuous adalimumab therapy had a significant effect on therapeutic outcomes.

Conclusion: Addition of MTX to adalimumab confers further therapeutic benefit in patients with RA, but not in those with PsA, suggesting differences in MTX effects in these two patient populations.

Clinicaltrials.gov NCT01078090, NCT01077258, NCT01111240
Y1  - 2019
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/81930
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-819305
SN  - 1502-7732
N1  - This work was supported by AbbVie Deutschland (Germany) GmbH & Co. KG (formerly Abbott GmbH & Co. KG). AbbVie designed and sponsored the observational study and provided funding for data acquisition, data analyses, and medical writing services. AbbVie was also involved in the review and approval of the manuscript.
VL  - 48
IS  - 5
SP  - 375
EP  - 382
PB  - Taylor & Francis
CY  - Abingdon
ER  -