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Comparing methotrexate monotherapy with methotrexate plus leflunomide combination therapy in psoriatic arthritis

MDlinx Apr 27, 2022

Why this study matters

Conventional synthetic DMARDs are currently first-line treatment for patients with PsA; however, optimal dosing and combination therapies have not been established.

This study showed that MTX plus LFM combination therapy is superior to MTX alone in the treatment of PsA, but not without increased untoward effects.

Study design

Seventy-eight patients (median age = 55 y) with a psoriatic arthritis disease activity score (PASDAS) > 5.4 were randomly stratified to one of the following groups and treated for 16 w: MTX (15 mg/w x 4 w, then 25 mg/w) + placebo; or MTX (15 mg/w x 4 w, then 25 mg/w) + LFM (10 mg x 2 qd).

Results and conclusion

The PASDAS after 16 w of treatment was 3.1 and 3.7 in the MTX + LFM combination and MTX monotherapy groups, respectively. Adverse events, such as nausea and vomiting, were mild, but more frequent in the combination treatment group.

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