Should You Add MTX to a TNF Inhibitor in Psoriasis? Save
Target emulation trial shows adding methotrexate (MTX) to adalimumab (ADA) does not augment the effectiveness and persistence of adalimumab alone in treating plaque psoriasis in adults.
Data from the British Association of Dermatologists Biologics and Immunomodulators Register (2007 to 2021) was used to compare 231 psoriasisi patients on ADA plus MTX (the intervention arm) to 1553 PSO patients (comparator arm) with plaque psoriasis. The primary outcomes were drug survival function at 1 year with secondary outcomes of survival function at 3 years and 75% reduction in Psoriasis Area and Severity Index (PASI75) at 1 year and 3 years.
Nearly 40% were females with a median age of 43 years. Drug survival at 1 year was:
- 79.1% ADA alone
- 78.1% ADA + MTX
PASI75 at 1 year and 3 years was:
- ADA alone: 52.0% and 32.4%
- ADA+MTX: 49.4% and 37.2%
Safety profiles were similar and there was no increase in serious adverse events between groups.
Concomitant methotrexate does not improve the effectiveness or duration of response in psoriasis patients treated wtih adalimumab.
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