title: Efficacy of methotrexate and tumor necrosis factor inhibitors in Japanese patients with active psoriatic arthritis.
abstract: OBJECTIVE
  The aim of this study was to assess the efficacy of oral methotrexate and tumor necrosis factor inhibitors in Japanese patients with active psoriatic arthritis.
  
  
  METHODS
  We retrospectively investigated 51 patients who fulfilled the ClASsification criteria for Psoriatic ARthritis (CASPAR) criteria for the efficacy of tumor necrosis factor inhibitors and methotrexate. We assessed the visual analog scale score, psoriasis area and severity index score, C-reactive protein-based disease activity score in 28 joints (DAS28), swollen joint count (0-66), tender joint count (0-68), health assessment questionnaire score, C-reactive protein level, erythrocyte sedimentation rate, and matrix metalloproteinase 3, at both baseline and week 24.
  
  
  RESULTS
  Of the 51 patients, 34 were male and 17 were female, with a mean age of 50.3 ± 13.2 years. The duration of psoriasis to onset of arthritis was 10.2 ± 9.1 years. At week 24, in the group treated with the tumor necrosis factor inhibitor plus methotrexate, the tender joint count declined from 6.05 ± 5.84 to 0.43 ± 1.03, the swollen joint count declined from 6.42 ± 4.36 to 0.00 ± 0.00, and the DAS28 declined from 4.35 ± 0.82 to 2.04 ± 0.68. In the group treated with methotrexate alone, the tender joint count declined from 3.70 ± 1.76 to 0.60 ± 0.86, the swollen joint count declined from 5.26 ± 4.00 to 0.27 ± 0.70, and the DAS28 declined from 3.91 ± 0.82 to 1.94 ± 0.53. There were no significant differences in the mean reduction in clinical measurements between the two groups.
  
  
  CONCLUSIONS
  Our study demonstrated that methotrexate and tumor necrosis factor inhibitors are effective for the treatment of active psoriatic arthritis in Japanese patients.
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine , Sendai, Miyagi , Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Mori
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kuwahara
authors.forename: Shinpei
authors.initials: S
authors.lastname: Chiba
authors.forename: Eiji
authors.initials: E
authors.lastname: Itoi
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use; D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D002097:C-Reactive Protein; D004359:Drug Therapy, Combination; D000068800:Etanercept / Q000627:therapeutic use; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use; D007564:Japan; D008297:Male; D019278:Matrix Metalloproteinase 3 / Q000097:blood; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D000069285:Infliximab; C511768:MMP3 protein, human; D019278:Matrix Metalloproteinase 3; D000068879:Adalimumab; D000068800:Etanercept; D008727:Methotrexate
keywords: Methotrexate; Psoriasis; Psoriatic arthritis; Tumor necrosis factor inhibitors