Can etanercept treatment failure in moderate-to-severe psoriasis be overcome by addition of low-dose methotrexate? A single-center experience

The Journal of Dermatological Treatment
Shany ShermanLev Pavlovsky

Abstract

Loss of efficacy is a major anticipated shortcoming of utilizing etanercept and other biologic agents for treating moderate-to-severe psoriasis. To investigate the addition of low-dose methotrexate as a means to increase etanercept drug survival. Eleven patients with severe psoriasis were switched to a combination of etanercept with low-dose methotrexate therapy, after a primary or secondary failure with etanercept treatment as a monotherapy. Time period for cessation of combined treatment and side effects were documented. The effect of previous methotrexate treatment was investigated. Six men and five women were included in the study. The patients had moderate-to-severe psoriasis with a mean baseline Psoriasis Area and Severity Index (PASI) of 29 (median 25). Median duration of etanercept monotherapy was 12 months. Median duration of combined treatment was 13 months. Combined treatment was discontinued in three patients due to side effects. Previous failure of methotrexate monotherapy did not alter the duration of the combined treatment. Addition of low-dose methotrexate may rescue etanercept therapy after failure of etanercept monotherapy in patients with moderate-to-severe psoriasis.

References

Nov 25, 2003·The New England Journal of Medicine·Craig L LeonardiUNKNOWN Etanercept Psoriasis Study Group
May 12, 2007·American Journal of Clinical Dermatology·Alberto Romero-MatéSusana Córdoba-Guijarro
Jan 15, 2010·The New England Journal of Medicine·Christopher E M GriffithsUNKNOWN ACCEPT Study Group
Jan 18, 2012·Archives of Dermatology·Sylvia HsuUNKNOWN National Psoriasis Foundation Medical Board
Oct 25, 2012·The British Journal of Dermatology·J Leman, A D Burden
Jul 24, 2013·The Journal of Dermatological Treatment·Ethan C LevinJohn Koo
Oct 15, 2013·The British Journal of Dermatology·J M P A van den ReekE M G J de Jong
Oct 15, 2013·The British Journal of Dermatology·L HsuA W Armstrong
Dec 18, 2013·The British Journal of Dermatology·T BitoC Nishigori
Dec 11, 2014·Journal of the European Academy of Dermatology and Venereology : JEADV·J SpertinoL Puig
May 13, 2015·American Journal of Clinical Dermatology·Michael E Farhangian, Steven R Feldman
Apr 14, 2016·Journal of the European Academy of Dermatology and Venereology : JEADV·J C PrinzG Girolomoni
Jan 1, 2017·Journal of the American Academy of Dermatology·Guy ShalomLev Pavlovsky

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