Takeaway
- Initiation of golimumab (TNF inhibitor) plus methotrexate combination therapy in patients with early, methotrexate-naive psoriatic arthritis was associated with higher number of patients achieving Disease Activity Score (DAS) remission vs placebo+methotrexate.
Why this matters
- Findings support early intervention in psoriatic arthritis over classical approach.
Study design
- Double-blind, randomised, placebo-controlled trial.
- 51 patients were psoriatic arthritis were randomly assigned to golimumab+methotrexate (n=26) or matched placebo+methotrexate (n=25; methotrexate group).
- Primary endpoint: patients achieving DAS remission (<1.6) at week 22.
- Funding: MSD.
Key results
- At week 22, 81% of patients with psoriatic arthritis achieved DAS remission with golimumab +methotrexate vs 42% with placebo+methotrexate (P=.004).
- Patients receiving golimumab+methotrexate reached a Minimal Disease Activity in 81% vs 29% in the methotrexate group (P<.001); Disease Activity Psoriatic Arthritis low disease activity was achieved in 92% vs 54% (P=.001).
- The American College of Rheumatology response criteria 20/50/70 response was achieved by 85%, 81% and 58%, respectively, in the golimumab+methotrexate vs 58%, 33% and 13%, respectively, in the methotrexate group (P=.039, .001 and .001, respectively).
- The rates of adverse event and treatment emergent adverse event were similar in both arms.
Limitations
- Magnetic resonance imaging or ultrasound was not included to evaluate the presence or absence of active synovitis or enthesitis.
References
References
