RESEARCH - The effectiveness and retention rates of MTX in psoriatic arthritis and in RA

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Ann Rheum Dis. 2009 Sep 9.

The effectiveness and retention rates of methotrexate in psoriatic

arthritis with methotrexate treated patients with rheumatoid arthritis

as a reference population.

Lie E, van der Heijde DM, Uhlig T, Heiberg MS, Koldingsnes W, Rødevand

E, Kaufmann C, Mikkelsen K, Kvien TK.

Diakonhjemmet Hospital, Norway.

OBJECTIVE: To examine effectiveness and 2-year retention rates of

methotrexate (MTX) in MTX naïve patients with psoriatic arthritis

(PsA).

METHODS: We analyzed data on 430 PsA patients participating in an

ongoing longitudinal observational multicenter study in Norway. 1218

MTX naïve rheumatoid arthritis (RA) patients from the same study

served as a reference population. Assessments included measures of

disease activity (28-joint counts, acute phase reactants), health

status and utility scores. Six-month effectiveness data were compared

both by crude analyses and with adjustments for age, sex and the

respective baseline values. Two-year drug survival was compared by

Kaplan-Meier and regression analyses.

RESULTS: /B> After 6 months of MTX treatment, both PsA and RA patients

improved in most disease activity measures and patient reported

outcomes. In the adjusted analysis PsA patients tended to have less

improvement, but changes were in the same range as in RA patients.

Two-year retention rates of MTX therapy in PsA and RA patients were

65% and 66%, respectively, with only minor differences in reported

reasons for discontinuation. Lower age, longer disease duration, and

higher MHAQ score and patient global assessment were independent

predictors of MTX termination within the first two years of treatment.

CONCLUSION: /B> In this real life study, MTX treatment was associated

with improvement of disease activity and health related quality of

life in PsA patients after 6 months of therapy. Retention rates of MTX

were similar in PsA and RA.

PMID: 19740904

http://www.ncbi.nlm.nih.gov/pubmed/19740904

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