Addition of Golimumab to Methotrexate/Corticosteroids to Manage Psoriatic Arthritis
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on December 22nd, 2025
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Patients with a history of skin psoriasis had a higher risk of developing psoriatic arthritis in the future. The current standard treatment regimen is a combination of corticosteroid, methotrexate, and biologic drug inhibiting the inflammatory pathway. Due to the higher cost of the biologic agents, it is frequently unavailable in developing countries. With funding from Janssen, a study was conducted to investigate the clinical effect of golimumab in treating psoriatic arthritis.
The phase 3 clinical trial included 84 participants with an average age of 42.5 years old who had been diagnosed with psoriatic arthritis within the previous 24 months, but have not been treated with any form of antirheumatic agents. Assessment with the Psoriatic Arthritis Disease Activity Score yielded a mean baseline score of 5.7, with a score higher than 28 meaning severe disease. The scale assesses tenderness & swelling of different joints, and it takes into account the patient's C-reactive protein level.
The participants were randomly assigned to receive a subcutaneous injection with either placebo or 50 mg of golimumab every 4 weeks; this dose is increased to 100 mg for participants above 100 kg. Golimumab reduced the severity of psoriatic arthritis by blocking the interaction between the pro-inflammatory cytokine, TNF-alpha, and its receptors. Additionally, the patients were treated with intramuscular/intra-articular methylprednisolone and oral methotrexate.
After 52 weeks of treatment, the researchers both regimens, containing golimumab or not, were effective at reducing psoriatic arthritis severity. However, there was no significant improvement in clinical benefits with the addition of golimumab to the methotrexate/prednisolone combination. The researchers noted that the sample size of this study is small, but it is statistically adequate to compare the clinical efficacy between these two regimens. Another limitation of this study is that it was conducted at a single hospital in the United Kingdom. Future studies exploring this relationship should also consider using other classes of antirheumatic drugs.
The phase 3 clinical trial included 84 participants with an average age of 42.5 years old who had been diagnosed with psoriatic arthritis within the previous 24 months, but have not been treated with any form of antirheumatic agents. Assessment with the Psoriatic Arthritis Disease Activity Score yielded a mean baseline score of 5.7, with a score higher than 28 meaning severe disease. The scale assesses tenderness & swelling of different joints, and it takes into account the patient's C-reactive protein level.
The participants were randomly assigned to receive a subcutaneous injection with either placebo or 50 mg of golimumab every 4 weeks; this dose is increased to 100 mg for participants above 100 kg. Golimumab reduced the severity of psoriatic arthritis by blocking the interaction between the pro-inflammatory cytokine, TNF-alpha, and its receptors. Additionally, the patients were treated with intramuscular/intra-articular methylprednisolone and oral methotrexate.
After 52 weeks of treatment, the researchers both regimens, containing golimumab or not, were effective at reducing psoriatic arthritis severity. However, there was no significant improvement in clinical benefits with the addition of golimumab to the methotrexate/prednisolone combination. The researchers noted that the sample size of this study is small, but it is statistically adequate to compare the clinical efficacy between these two regimens. Another limitation of this study is that it was conducted at a single hospital in the United Kingdom. Future studies exploring this relationship should also consider using other classes of antirheumatic drugs.