title: The combination of etanercept and methotrexate increases the effectiveness of treatment in active psoriasis despite inadequate effect of methotrexate therapy.
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 > or = 8 and/or body surface area > 10%), despite methotrexate treatment (> or = 3 months; > or = 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.
authors.affiliation: Department of Dermatology, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Claus
authors.initials: C
authors.lastname: Zachariae
authors.forename: Nils-Jørgen
authors.initials: NJ
authors.lastname: Mørk
authors.forename: Timo
authors.initials: T
authors.lastname: Reunala
authors.forename: Henrik
authors.initials: H
authors.lastname: Lorentzen
authors.forename: Edvard
authors.initials: E
authors.lastname: Falk
authors.forename: Seija-Liisa
authors.initials: SL
authors.lastname: Karvonen
authors.forename: Anders
authors.initials: A
authors.lastname: Johannesson
authors.forename: Birgitta
authors.initials: B
authors.lastname: Claréus
authors.forename: Lone
authors.initials: L
authors.lastname: Skov
authors.forename: Gro
authors.initials: G
authors.lastname: Mørk
authors.forename: Siân
authors.initials: S
authors.lastname: Walker
authors.forename: Susanne
authors.initials: S
authors.lastname: Qvitzau
mesh_terms: D004359:Drug Therapy, Combination; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D010865:Pilot Projects; D011565:Psoriasis / Q000188:drug therapy*; D011788:Quality of Life; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D012720:Severity of Illness Index
chemical_list: D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept; D008727:Methotrexate