Objective. To evaluate the efficacy and safety of methotrexate (MTX) treatment in early psoriatic arthritis (EPA). Methods. 35 patients with EPA oligoarthritic subset (17 F – 18 M; mean age 25.6 yrs) entered this randomised 6 months study. At the enrolment all patients were on NSAID therapy at full dosage and were divided in 2 matched groups (A and B). Group A continued in the following 3 months NSAID therapy and then added for 3 months MTX. Group B was for the entire 6 months period under the association NSAID and MTX. 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 three (T3) and at six months (T6). Results. After 3 and 6 months in group B there was a significant improvement of all variables evaluated. In group A, after the first 3 months of therapy, there was a significant improvement of the observed variables which was also confirmed at the end of the 3 months period of treatment with MTX. However, as compared to patients of group A, after 3 months, patients included in group B showed a marked improvement of TJC and SJC. In contrast, PGA, PhGA, VAS, ESR and CRP variations were not significantly different. Conclusion. The early use of MTX in EPA patients markedly improves the count of tender and swollen joints. In fact, at T3 other markers used to quantify EPA disease activity, in particuklar VAS,ESR and CRP, did not show significant differences in EPA patients treated either with NSAIDs or MTX. This suggests an incomplete control of the pathogenetic process and stimulates further interest on early use of other approaches able to modify the course of disease.

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

SCARPA, RAFFAELE;PELUSO, ROSARIO;ATTENO, MARIANGELA;MANGUSO, FRANCESCO;IERVOLINO, SALVATORE;DI MINNO, MATTEO;COSTA, LUISA;DEL PUENTE, ANTONIO
2008

Abstract

Objective. To evaluate the efficacy and safety of methotrexate (MTX) treatment in early psoriatic arthritis (EPA). Methods. 35 patients with EPA oligoarthritic subset (17 F – 18 M; mean age 25.6 yrs) entered this randomised 6 months study. At the enrolment all patients were on NSAID therapy at full dosage and were divided in 2 matched groups (A and B). Group A continued in the following 3 months NSAID therapy and then added for 3 months MTX. Group B was for the entire 6 months period under the association NSAID and MTX. 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 three (T3) and at six months (T6). Results. After 3 and 6 months in group B there was a significant improvement of all variables evaluated. In group A, after the first 3 months of therapy, there was a significant improvement of the observed variables which was also confirmed at the end of the 3 months period of treatment with MTX. However, as compared to patients of group A, after 3 months, patients included in group B showed a marked improvement of TJC and SJC. In contrast, PGA, PhGA, VAS, ESR and CRP variations were not significantly different. Conclusion. The early use of MTX in EPA patients markedly improves the count of tender and swollen joints. In fact, at T3 other markers used to quantify EPA disease activity, in particuklar VAS,ESR and CRP, did not show significant differences in EPA patients treated either with NSAIDs or MTX. This suggests an incomplete control of the pathogenetic process and stimulates further interest on early use of other approaches able to modify the course of disease.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/357612
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