Methotrexate in psoriatic polyarthritis

Methotrexate (MTX) is widely accepted as an effective treatment for psoriasis and chronic polyarthrides. We report data from 54 psoriatic polyarthritis patients (354 encounters) treated with MTX. 65% were males, mean age 47.9 years, mean disease duration 9.8 years for arthritis, 14.2 years for psoriasis. The MTX dose was 10-12.5 mg/week. 32 patients are still on MTX after a mean treatment time of 1.6 years. 22 patients discontinued MTX treatment: 11 felt it to be ineffective, in 6 patients there were side effects, 3 patients obtained remission, while 2 patients underwent surgery. Efficacy was good on the whole: number of swollen and tender joints, global disease activity score, ESR, and CRP all underwent a significant reduction. The intake of symptomatic drugs was reduced in 40%. Psoriasis as assessed with the Psoriasis Activity and Severity Index showed a significant improvement. Our data confirm that MTX is of value in most psoriatic polyarthritis patients (60%). In our experience, this drug, gives the maximum efficacy within 6 months of therapy.