Methotrexate Helps Biologics Stay Effective, According to Study

| Melissa Leavitt

Has your doctor prescribed methotrexate for you to take along with your biologic?

Many people with psoriasis and psoriatic arthritis discover that their biologic stops working after a while. When that happens, doctors sometimes prescribe methotrexate, which can help prolong the biologic’s beneficial effects. An article in the March issue of The Dermatologist examined the results of this combined therapy, and found that it can be useful for many patients.

In “Using Biologic Agents in Combination with Methotrexate in Psoriasis Therapy,” researchers reviewed past studies and considered their own clinical experience. Their article “shows the growing evidence that the combination of methotrexate with biologic therapies is a safe and effective practice,” said Dr. CaitrÍona Ryan, one of the authors.

Biologics, such as Enbrel (etanercept), Humira (adalimumab), Remicade (infliximab) and Stelara (ustekinumab), are derived from living cells, and target specific parts of the immune system. Methotrexate, on the other hand, is a systemic drug, which means it affects the entire immune system.

The research team, which included physicians from Baylor University Medical Center’s Psoriasis Specialty Clinic, reported that approximately 40 percent of patients at their clinic who take Enbrel, Remicade or Humira also take methotrexate to improve their response to the therapy. In addition, many clinic patients taking Stelara also take methotrexate to increase benefits from the biologic.

A 2011 study from the clinic revealed that 52 percent of patients taking Remicade required methotrexate to continue seeing improvements. Other studies of Remicade and methotrexate indicate that the two medications together can successfully reduce symptoms of psoriasis and psoriatic arthritis, the researchers report.

Studies of Humira and Enbrel in conjunction with methotrexate also revealed the combination to be more effective than the biologic alone.

Future directions for research include examining whether taking methotrexate in combination with a biologic could reduce the risk for cardiovascular disease, Ryan said.

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