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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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-04-01
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| Series: | Dermatologica Sinica |
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| Online Access: | https://journals.lww.com/10.4103/ds.DS-D-24-00194 |
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| author | Ting-Ting Cheng Yang Lo |
| author_facet | Ting-Ting Cheng Yang Lo |
| author_sort | Ting-Ting Cheng |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-7beee538369d4c1c8b891f43330516ef |
| institution | DOAJ |
| issn | 1027-8117 2223-330X |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Dermatologica Sinica |
| spelling | doaj-art-7beee538369d4c1c8b891f43330516ef2025-08-20T03:19:57ZengWolters Kluwer Medknow PublicationsDermatologica Sinica1027-81172223-330X2025-04-01432819010.4103/ds.DS-D-24-00194Role of methotrexate in biologics use with psoriasis and psoriatic arthritisTing-Ting ChengYang LoBiologic 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.https://journals.lww.com/10.4103/ds.DS-D-24-00194biologicsmethotrexatepsoriasis |
| spellingShingle | Ting-Ting Cheng Yang Lo Role of methotrexate in biologics use with psoriasis and psoriatic arthritis Dermatologica Sinica biologics methotrexate psoriasis |
| title | Role of methotrexate in biologics use with psoriasis and psoriatic arthritis |
| title_full | Role of methotrexate in biologics use with psoriasis and psoriatic arthritis |
| title_fullStr | Role of methotrexate in biologics use with psoriasis and psoriatic arthritis |
| title_full_unstemmed | Role of methotrexate in biologics use with psoriasis and psoriatic arthritis |
| title_short | Role of methotrexate in biologics use with psoriasis and psoriatic arthritis |
| title_sort | role of methotrexate in biologics use with psoriasis and psoriatic arthritis |
| topic | biologics methotrexate psoriasis |
| url | https://journals.lww.com/10.4103/ds.DS-D-24-00194 |
| work_keys_str_mv | AT tingtingcheng roleofmethotrexateinbiologicsusewithpsoriasisandpsoriaticarthritis AT yanglo roleofmethotrexateinbiologicsusewithpsoriasisandpsoriaticarthritis |