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Etanercept and methotrexate as first-line treatment in PsA

Presented By
Prof. Philip Mease, University of Washington, USA
EULAR 2019
Phase 3, SEAM-PsA
There is conclusive evidence from the phase 3 SEAM-PsA trial that both etanercept and combined treatment of etanercept and methotrexate are more efficacious than methotrexate monotherapy in patients with psoriatic arthritis (PsA) naïve to biologic drugs. Combining etanercept and methotrexate offers little benefit over etanercept monotherapy. Compared with the joint-focused DAPSA, PASDAS captured a wider range of PsA manifestations and performed better in this trial [1]. The benefits of methotrexate alone and in combination with tumour necrosis factor inhibitor (TNFi) therapy have been demonstrated in RA, but the same cannot be said for PsA. Studies of methotrexate monotherapy in PsA have been largely mixed [2]. “How do we optimally use methotrexate in combination with TNFi therapy in PsA patients naïve to biologics,” asked Prof. Philip Mease (University of Washington, USA). “There has been very little trial data looking at methotrexate in PsA, and we thoug...

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