Systematic Review

Combination of methotrexate with oral disease-modifying antirheumatic drugs in psoriatic arthritis: a systematic review

Department of Dermatology, National Taiwan University Hospital & National Taiwan University College of Medicine, Taipei, 10002, Taiwan

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Tsen-Fang Tsai

*Author for correspondence:

E-mail Address: tftsai@yahoo.com

https://orcid.org/0000-0002-1498-1474

Department of Dermatology, National Taiwan University Hospital & National Taiwan University College of Medicine, Taipei, 10002, Taiwan

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Published Online:19 Dec 2023https://doi.org/10.2217/imt-2023-0139

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Abstract

Background: Oral conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), especially methotrexate, are the cornerstone of treating psoriatic arthritis (PsA). The use of csDMARDs with biologics has increased their efficacy in psoriasis. However, the combination of two oral DMARDs in patients with PsA has not been adequately reviewed. In this study, we explore the combinational use of methotrexate with DMARDs in PsA patients. Materials & methods: A review was conducted using Medline (PubMed), Embase, Web of Science and the Cochrane Library, covering articles up to February 2023. Results & conclusion: Nine studies comprising 1993 participants were included. The evidence supporting combination therapy remains limited. Combinational therapy could be considered in patients with inadequate response to monotherapy or no access to biologics.

Plain language summary

This study aimed to determine whether combining two different medicines could serve as an option for patients with psoriatic arthritis (PsA). Typically, doctors prescribe just one medicine, but sometimes its efficacy is limited. After reviewing nine studies with 1993 participants, it appears that using two medicines together might be an alternative option for PsA patients who do not experience sufficient relief from a single medicine. This research contributes to our understanding of using this combination approach for PsA and suggests that further larger studies could confirm its potential as a beneficial method for improving the health of these patients.

Keywords:

Papers of special note have been highlighted as: • of interest; •• of considerable interest

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Vol. 16, No. 2

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Received 30 June 2023

Accepted 13 November 2023

Published online 19 December 2023

Published in print February 2024

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Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.futuremedicine.com/doi/suppl/10.2217/imt-2023-0139

Author contributions

Conceptualization: T-F Tsai. Methodology: T-F Tsai and T-S Hsieh. Formal analysis and investigation: T-F Tsai and T-S Hsieh. Writing – original draft preparation: T-S Hsieh. Writing – review and editing: T-F Tsai. Supervision: T-F Tsai.

Financial disclosure

The authors have no financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Competing interests disclosure

T-F Tsai has conducted clinical trials or received honoraria for serving as a consultant for AbbVie, AnaptysBio, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, EliLilly, Galderma, GSK-Stiefel, Janssen-Cilag, Leo-Pharma, Merck, Novartis, PharmaEssentia, Pfizer, Sanofi, Sun Pharma and UCB. The authors have no other competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript apart from those disclosed. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

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