Psoriatic arthritis: early TNF inhibition achieves remission in more patients

  • van Mens LJJ & al.
  • Ann Rheum Dis
  • 26 Feb 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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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 (
  • 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 was achieved in vs>
  • 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.

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