Role of methotrexate in biologics use with psoriasis and psoriatic arthritis
Biologic agents have significantly improved treatment outcomes for psoriasis and psoriatic arthritis (PsA). However, their long-term effectiveness can decline due to the formation of anti-drug antibodies. The off-label addition of methotrexate (MTX) to biologics offers benefits through synergistic a...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2025-04-01
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| Series: | Dermatologica Sinica |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/ds.DS-D-24-00194 |
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| Summary: | Biologic agents have significantly improved treatment outcomes for psoriasis and psoriatic arthritis (PsA). However, their long-term effectiveness can decline due to the formation of anti-drug antibodies. The off-label addition of methotrexate (MTX) to biologics offers benefits through synergistic antipsoriatic effects and reduced immunogenicity, primarily by increasing extracellular adenosine levels and inducing the anergy state of T and B cells. In patients with psoriasis, the addition of MTX has been shown to improve the efficacy of tumor necrosis factor-α inhibitors, although controlled data on its combination with interleukin (IL)-17 or IL-23 inhibitors are limited. In PsA, however, combination therapy with MTX provides little to no additional efficacy compared to biologic monotherapy. |
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| ISSN: | 1027-8117 2223-330X |