Funding source: None.
Low-dose methotrexate – a therapeutical kick in TNF-alpha antagonist treatment for recalcitrant psoriasis vulgaris
Article first published online: 2 APR 2013
© 2013 Wiley Periodicals, Inc.
Volume 27, Issue 1, pages 55–59, January/February 2014
How to Cite
Wilsmann-Theis, D., Fronhoffs, K., Ehler, L.-K., Wenzel, J., Bieber, T. and Klingmueller, K. (2014), Low-dose methotrexate – a therapeutical kick in TNF-alpha antagonist treatment for recalcitrant psoriasis vulgaris. Dermatologic Therapy, 27: 55–59. doi: 10.1111/dth.12046
Conflict of interest:
D. Wilsmann-Theis received financial support for performing clinical trials, has served as a consultant for or has received speakers' honoraria and travel scholarships from Abbott GmbH & Co. KG and Pfizer GmbH.
K. Klingmueller, Th.Bieber, L.Ehler, K.Fronhoffs, and J.Wenzel declare no conflict of interest.
- Issue published online: 6 FEB 2014
- Article first published online: 2 APR 2013
- psoriasis vulgaris;
- TNF-alpha inhibitor
In contrast to the treatment of rheumatoid arthritis, there are few data in psoriasis vulgaris regarding the efficacy of combining tumor necrosis factor (TNF)-alpha inhibitors and methotrexate (MTX). Indeed, combination of MTX with different TNF-alpha inhibitors may enhance the therapeutic effects and reduce side effects because of less dosage of the single agent. The present authors present five cases in which low-dose MTX combined with TNF-alpha inhibitors led to impressive improvement in Psoriasis Area and Severity Index scores. Here, the present authors initiated very low-dose MTX treatment in addition to existing TNF-alpha inhibitor therapy to exhaust current therapy and prevent premature change of the biologic. These observations support the concept of combined treatment in recalcitrant cases of psoriasis, which need a systemically lifelong treatment when both first-line and second-line monotherapies fail to provide sufficient clinical response.