26 Aprile 2022
K A Papp, M J Gooderham, L E Albrecht, M-A Raymond, C W Lynde

Treatment satisfaction, safety and effectiveness of adding methotrexate to adalimumab in patients with psoriasis responding suboptimally to adalimumab in a real-world setting

Br J Dermatol. 2022 Apr;186(4):726-728

Key messages

  • Fino al 30% dei pazienti affetti da psoriasi in trattamento con farmaci biologici può manifestare un’inadeguata risposta al trattamento.
  • In questo studio real-world di 24 settimane, l’aggiunta di metotrexato ad adalimumab ha aumentato il tasso di soddisfazione, l’efficacia terapeutica e la qualità di vita dei pazienti con pregressa risposta sub-ottimale ad adalimumab in monoterapia. Non ci sono stati nuovi segnali relativi alla sicurezza.


An inadequate response to biologics may reach 30% in patients with psoriasis. In other inflammatory diseases, a positive effect of adding methotrexate (MTX) to adalimumab (ADA) has been reported. In this real-world, Canadian multicentre, single-arm, phase IIIb, open-label study, suboptimal responders who have been receiving ADA for ≥16 weeks, who had a Physician’s Global Assessment (PGA) ≥3 and Psoriasis Area Severity Index (PASI) ≥5, continued to self-administer ADA (40 mg every other week). Oral MTX was added (10-25 mg per week as per investigator’s decision and could vary throughout the study), as well as folic acid (1-mg tablet daily) for 24 weeks.

In a real-world setting over 24 weeks, adding MTX to ADA increased treatment satisfaction, effectiveness and quality of life in patients with psoriasis suboptimally responding to ADA monotherapy. No new safety signals were detected.

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