TNFi as a Combination Therapy and Comedication With Methotrexate is Associated With Improved Remission Rates of Psoriatic Arthritis

Conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and tumor necrosis factor inhibitors (TNFi) comedication increase remission rates in patients with psoriatic arthritis (PsA).

“We aimed to compare treatment outcomes in patients with PsA treated with TNFi and csDMARD comedication versus TNFi monotherapy,” explained the study authors.

Researchers conducted an observational study in patients with PsA from 13 European countries who initiated a first TNFi in 2006 to 2017. Comparisons of the 1-year TNFi retention were performed by csDMARD comedication status. In total, 15,332 patients were included, with 62% receiving comedication and 38% receiving monotherapy.

Comedication was associated with improved remission rates. Improved remission with methotrexate comedication for adalimumab was OR 1.45 (1.23–1.72) and OR 1.55 (1.21–1.98) for infliximab.

“This large observational study suggests that, as used in clinical practice, csDMARD and TNFi comedication are associated with improved remission rates, and specifically, comedication with methotrexate increases remission rates for both adalimumab and infliximab,” concluded the study authors.

Reference
Lindström U, Di Giuseppe D, Delcoigne B, et al. Effectiveness and treatment retention of TNF inhibitors when used as monotherapy versus comedication with csDMARDs in 15 332 patients with psoriatic arthritis. Data from the EuroSpA collaboration. Ann Rheum Dis. Published online June 3, 2021. doi:10.1136/annrheumdis-2021-220097