Patterns of Medication Use in a Validated Cohort of Psoriatic Arthritis (PsA) Patients
There is currently a lack of consensus on the best first-line treatment for psoriatic arthritis (PsA): whether to prescribe a classic synthetic disease-modifying anti-rheumatic drug (DMARD), such as methotrexate, or a biologic treatment. In clinical practice, it is assumed that treatment with a DMARD, usually methotrexate, precedes therapy with biologic agents. Researchers at HSS evaluated the use of methotrexate and found that nearly 9 out of 10 patients in an academic Psoriatic Arthritis Registry received it prior to a biologic drug, and 32.4 percent of methotrexate users remained on it. Even among those who discontinued, 43.1 percent believed it helped their condition. Researchers noted that these findings suggest a benefit from methotrexate and that even in a center where patients and physicians have access to biologics, methotrexate remains the standard of care as initial therapy. Given the lower cost and patients’ report of benefit, researchers concluded that in selected patients, methotrexate should remain a first-line treatment.