The effectiveness of a traditional therapeutical approach in early psoriatic arthritis: Results of a pilot randomised 6-month trial with methotrexate

Raffaele Scarpa, Rosario Peluso, Mariangela Atteno, Francesco Manguso, Angelo Spanò, Salvatore Iervolino, Matteo Nicola Dario Minno, Luisa Costa, Antonio Puente

Research output: Contribution to journalArticlepeer-review

Abstract

Thirty-five patients with Early Psoriatic Arthritis (EPA) (17 female and 18 male; mean age 25.6 years) entered this randomised 6-month study. At the enrolment, all patients were on non-steroidal anti-inflammatory drug (NSAID) therapy on demand and were divided in two matched groups (A and B). Group A continued NSAID therapy at full dosage in the following 3 months and then added methotrexate (MTX) for another 3 months. Group B was under the combination of NSAID and MTX for the entire 6-month period. Clinical and laboratory assessment included the count of tender joints and/or entheses (TJC), the count of swollen joints and/or entheses (SJC), patient's global assessment (PGA), physician's global assessment (PhGA), patient's assessment of pain (VAS), erythrocyte sedimentation rate (ESR) and serum concentration of C-reactive protein (CRP). All variables were done at baseline (T0), at 3 (T3) and at 6 months (T6). In both group A and in group B, there was a significant improvement of all variables at T3 and T6. However, in comparison to the patients of group A, patients included in group B showed a more rapid and marked improvement of TJC and SJC, which was statistically significant at T3 (p <0.05). In contrast, the improvement of PGA, PhGA, VAS, ESR and CRP was not significantly different between groups. The early use of MTX in EPA patients markedly improves TJC and SJC. In fact, at T3, other markers used to quantify EPA disease activity, in particular PGA, PhGA, VAS, ESR and CRP, did not show significant differences in EPA patients treated with either NSAIDs or MTX. This finding suggests an incomplete control under MTX of the pathogenetic process and stimulates further interest on early use of other therapeutical approaches capable of modifying the course of disease.

Original languageEnglish
Pages (from-to)823-826
Number of pages4
JournalClinical Rheumatology
Volume27
Issue number7
DOIs
Publication statusPublished - Jul 2008

Keywords

  • DMARDs in early psoriatic arthritis
  • Early arthritis
  • Psoriatic arthritis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology

Fingerprint

Dive into the research topics of 'The effectiveness of a traditional therapeutical approach in early psoriatic arthritis: Results of a pilot randomised 6-month trial with methotrexate'. Together they form a unique fingerprint.

Cite this