{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T06:17:04Z","timestamp":1771654624852,"version":"3.50.1"},"reference-count":18,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T00:00:00Z","timestamp":1683849600000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement."},{"DOI":"10.13039\/501100007949","name":"Reumatikerf\u00f6rbundet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011077","name":"Sk\u00e5nes universitetssjukhus","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011077","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2023,4,27]]},"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>We aimed to compare the proportions of patients with newly diagnosed psoriatic arthritis (PsA) and rheumatoid arthritis (RA) remaining on methotrexate (regardless of other disease-modifying antirheumatic drug (DMARD)-changes), and proportions not having started another DMARD (regardless of methotrexate discontinuation), within 2\u2009years of starting methotrexate, as well as methotrexate effectiveness.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients with DMARD-na\u00efve, newly diagnosed PsA, starting methotrexate 2011\u20132019, were identified from high-quality national Swedish registers and matched 1:1 to comparable patients with RA. Proportions remaining on methotrexate and not starting another DMARD were calculated. For patients with disease activity data at baseline and 6\u2009months, response to methotrexate monotherapy was compared through logistic regression, applying non-responder imputation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 3642\/3642 patients with PsA\/RA were included. Baseline patient-reported pain and global health were similar, whereas patients with RA had higher 28-joint scores and evaluator-assessed disease activity. Two years after methotrexate start, 71% of PsA vs 76% of patients with RA remained on methotrexate, 66% vs 60% had not started any other DMARD, and 77% vs 74% had not started specifically a biological or targeted synthetic DMARD. At 6\u2009months, the proportions of patients with PsA versus RA achieving pain-scores \u226415\u2009mm were 26% vs 36%; global health \u226420\u2009mm: 32% vs 42%; evaluator-assessed \u2018remission\u2019: 20% vs 27%, with corresponding adjusted ORs (PsA vs RA) of 0.63 (95% CI 0.47 to 0.85); 0.57 (95% CI 0.42 to 0.76) and 0.54 (95% CI 0.39 to 0.75).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>In Swedish clinical practice, methotrexate use is similar in PsA and RA, both regarding initiation of other DMARDs and methotrexate retention. On a group level, disease activity improved during methotrexate monotherapy in both diseases, although more so in RA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2022-002883","type":"journal-article","created":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T09:55:40Z","timestamp":1683885340000},"page":"e002883","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Methotrexate treatment in early psoriatic arthritis in comparison to rheumatoid arthritis: an observational nationwide study"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2250-9348","authenticated-orcid":false,"given":"Ulf","family":"Lindstr\u00f6m","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"di Giuseppe","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofia","family":"Exarchou","sequence":"additional","affiliation":[{"name":"Rheumatology, Department of Clinical Sciences, Lund University, Malm\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerd-Marie","family":"Alenius","sequence":"additional","affiliation":[{"name":"Department of Public Health and Clinical Medicine\/Rheumatology, Ume\u00e5 University, Ume\u00e5, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9919-4487","authenticated-orcid":false,"given":"Tor","family":"Olofsson","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Rheumatology, Lund University, Skane University Hospital, Lund, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6858-6413","authenticated-orcid":false,"given":"Eva","family":"Klingberg","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lennart","family":"Jacobsson","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0433-0616","authenticated-orcid":false,"given":"Johan","family":"Askling","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan K","family":"Wallman","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Rheumatology, Lund University, Skane University Hospital, Lund, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,5,12]]},"reference":[{"key":"2025090312403534000_9.2.e002883.1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes001"},{"key":"2025090312403534000_9.2.e002883.2","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1002\/art.40851","article-title":"Etanercept and methotrexate as monotherapy or in combination for psoriatic arthritis: primary results from a randomized, controlled phase III trial","volume":"71","author":"Mease","year":"2019","journal-title":"Arthritis Rheumatol"},{"key":"2025090312403534000_9.2.e002883.3","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1002\/art.40726","article-title":"2018 American College of rheumatology\/national psoriasis Foundation guideline for the treatment of psoriatic arthritis","volume":"71","author":"Singh","year":"2019","journal-title":"Arthritis Rheumatol"},{"key":"2025090312403534000_9.2.e002883.4","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-217159"},{"key":"2025090312403534000_9.2.e002883.5","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.102053"},{"key":"2025090312403534000_9.2.e002883.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00347-5"},{"key":"2025090312403534000_9.2.e002883.7","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-007-0787-7"},{"key":"2025090312403534000_9.2.e002883.8","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780270403"},{"key":"2025090312403534000_9.2.e002883.9","doi-asserted-by":"crossref","unstructured":"Saurat J-H , Stingl G , Dubertret L , et al . n.d. Efficacy and safety results from the randomized controlled comparative study of adalimumab vs. methotrexate vs. placebo in patients with psoriasis (champion). British Journal of Dermatology;158:558\u201366. doi:10.1111\/j.1365-2133.2007.08315.x","DOI":"10.1111\/j.1365-2133.2007.08315.x"},{"key":"2025090312403534000_9.2.e002883.10","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.064808"},{"key":"2025090312403534000_9.2.e002883.11","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.113308"},{"key":"2025090312403534000_9.2.e002883.12","unstructured":"Clinicaltrials.Gov. 2022 Available: https:\/\/www.clinicaltrials.gov\/"},{"key":"2025090312403534000_9.2.e002883.13","article-title":"Methotrexate for treating rheumatoid arthritis","volume":"2014","author":"Lopez-Olivo","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"2025090312403534000_9.2.e002883.14","doi-asserted-by":"crossref","unstructured":"Waldenlind K , Eriksson JK , Grewin B , et al . Validation of the rheumatoid arthritis diagnosis in the swedish national patient register: a cohort study from stockholm county [BMC musculoskeletal disorders]. BMC Musculoskelet Disord 2014;15. doi:10.1186\/1471-2474-15-432 Available:","DOI":"10.1186\/1471-2474-15-432"},{"key":"2025090312403534000_9.2.e002883.15","doi-asserted-by":"crossref","unstructured":"Wallman JK , Alenius G-M , Klingberg E , et al . Validity of clinical psoriatic arthritis diagnoses made by rheumatologists in the Swedish national patient register. 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