Design and rationale of the Study of Etanercept and Methotrexate in Combination or as Monotherapy in Subjects with Psoriatic Arthritis (SEAM-PsA)

Philip J Mease, Dafna D Gladman, Ahmed S Samad, Laura C Coates, Lyrica X H Liu, Girish A Aras, David H Collier, James B Chung, Philip J Mease, Dafna D Gladman, Ahmed S Samad, Laura C Coates, Lyrica X H Liu, Girish A Aras, David H Collier, James B Chung

Abstract

Objective: To evaluate the efficacy of etanercept and methotrexate as monotherapies and as combination therapy in subjects with active psoriatic arthritis (PsA).

Methods: The Study of Etanercept and Methotrexate in Combination or as Monotherapy in Subjects with Psoriatic Arthritis (SEAM-PsA) is an ongoing, global, double-blind, 48-week, randomised, controlled study. Subjects are randomised (1:1:1) to etanercept monotherapy, methotrexate monotherapy or etanercept-methotrexate combination therapy. Endpoints include rates of ACR20 response and Minimal Disease Activity, measures to characterise extra-articular manifestations (dactylitis, enthesitis, nail disease) and safety.

Conclusion: SEAM-PsA will characterise the effects of etanercept with and without background methotrexate and methotrexate alone on PsA manifestations, and provide information of practical importance to clinicians on the optimal treatment of PsA.

Keywords: anti-TNF; methotrexate; psoriatic arthritis.

Conflict of interest statement

Competing interests: PJM has received research grants, served as a consultant, and/or participated as a speaker for AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Genentech, Janssen Global Services, Eli Lilly, Merck Sharp & Dohme, Novartis, Pfizer, Sun Pharma, UCB, and Zynerba Pharmaceuticals. DDG has received research funding from and/or been a consultant to AbbVie, Amgen, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen Global Services, Novartis, Pfizer, and UCB. ASS, LXHL, GAA, DHC and JBC are employees and shareholders of Amgen. LCC has received research funding from and/or been a consultant for AbbVie, Amgen, Celgene, Janssen Global Services, Eli Lilly, Merck Sharp & Dohme, Novartis, Pfizer, Sun Pharma, and UCB.

Figures

Figure 1
Figure 1
Study schema.

References

    1. Ogdie A, Weiss P. The epidemiology of psoriatic arthritis. Rheum Dis Clin North Am 2015;41:545–68. 10.1016/j.rdc.2015.07.001
    1. Gladman DD. Clinical features and diagnostic considerations in psoriatic arthritis. Rheum Dis Clin North Am 2015;41:569–79. 10.1016/j.rdc.2015.07.003
    1. Kingsley GH, Kowalczyk A, Taylor H, et al. . A randomized placebo-controlled trial of methotrexate in psoriatic arthritis. Rheumatology 2012;51:1368–77. 10.1093/rheumatology/kes001
    1. Mease PJ. Spondyloarthritis: Is methotrexate effective in psoriatic arthritis? Nat Rev Rheumatol 2012;8:251–2. 10.1038/nrrheum.2012.56
    1. D’Angelo S, Tramontano G, Gilio M, et al. . Review of the treatment of psoriatic arthritis with biological agents: choice of drug for initial therapy and switch therapy for non-responders. Open Access Rheumatol 2017;9:21–8. 10.2147/OARRR.S56073
    1. Mease PJ, Goffe BS, Metz J, et al. . Etanercept in the treatment of psoriatic arthritis and psoriasis: a randomised trial. Lancet 2000;356:385–90. 10.1016/S0140-6736(00)02530-7
    1. Fagerli KM, Lie E, van der Heijde D, et al. . The role of methotrexate co-medication in TNF-inhibitor treatment in patients with psoriatic arthritis: results from 440 patients included in the NOR-DMARD study. Ann Rheum Dis 2014;73:132–7. 10.1136/annrheumdis-2012-202347
    1. Mease PJ, Collier DH, Saunders KC, et al. . Comparative effectiveness of biologic monotherapy versus combination therapy for patients with psoriatic arthritis: results from the Corrona registry. RMD Open 2015;1:e000181 10.1136/rmdopen-2015-000181
    1. Thomas SS, Borazan N, Barroso N, et al. . Comparative immunogenicity of TNF inhibitors: impact on clinical efficacy and tolerability in the management of autoimmune diseases. A systematic review and meta-analysis. BioDrugs 2015;29:241–58. 10.1007/s40259-015-0134-5
    1. Klareskog L, van der Heijde D, de Jager JP, et al. . Therapeutic effect of the combination of etanercept and methotrexate compared with each treatment alone in patients with rheumatoid arthritis: double-blind randomised controlled trial. Lancet 2004;363:675–81. 10.1016/S0140-6736(04)15640-7
    1. Mease PJ, Kivitz AJ, Burch FX, et al. . Etanercept treatment of psoriatic arthritis: safety, efficacy, and effect on disease progression. Arthritis Rheum 2004;50:2264–72. 10.1002/art.20335
    1. Coates LC, Fransen J, Helliwell PS. Defining minimal disease activity in psoriatic arthritis: a proposed objective target for treatment. Ann Rheum Dis 2010;69:48–53. 10.1136/ard.2008.102053
    1. Coates LC, Helliwell PS. Validation of minimal disease activity criteria for psoriatic arthritis using interventional trial data. Arthritis Care Res 2010;62:965–9. 10.1002/acr.20155
    1. Coates LC, Moverley AR, McParland L, et al. . Effect of tight control of inflammation in early psoriatic arthritis (TICOPA): a UK multicentre, open-label, randomised controlled trial. Lancet 2015;386:2489–98. 10.1016/S0140-6736(15)00347-5
    1. Sheane BJ, Thavaneswaran A, Gladman DD, et al. . Attainment of minimal disease activity using methotrexate in psoriatic arthritis. J Rheumatol 2016;43:1718–23. 10.3899/jrheum.160111
    1. Coates LC, Cook R, Lee KA, et al. . Frequency, predictors, and prognosis of sustained minimal disease activity in an observational psoriatic arthritis cohort. Arthritis Care Res 2010;62:970–6. 10.1002/acr.20162
    1. Haddad A, Thavaneswaran A, Ruiz-Arruza I, et al. . Minimal disease activity and anti-tumor necrosis factor therapy in psoriatic arthritis. Arthritis Care Res 2015;67:842–7. 10.1002/acr.22529
    1. Ortonne JP, Paul C, Berardesca E, et al. . A 24-week randomized clinical trial investigating the efficacy and safety of two doses of etanercept in nail psoriasis. Br J Dermatol 2013;168:1080–7. 10.1111/bjd.12060
    1. Gümüşel M, Özdemir M, Mevlitoğlu I, et al. . Evaluation of the efficacy of methotrexate and cyclosporine therapies on psoriatic nails: a one-blind, randomized study. J Eur Acad Dermatol Venereol 2011;25:1080–4. 10.1111/j.1468-3083.2010.03927.x
    1. Mease PJ. Measures of psoriatic arthritis: Tender and Swollen Joint Assessment, Psoriasis Area and Severity Index (PASI), Nail Psoriasis Severity Index (NAPSI), Modified Nail Psoriasis Severity Index (mNAPSI), Mander/Newcastle Enthesitis Index (MEI), Leeds Enthesitis Index (LEI), Spondyloarthritis Research Consortium of Canada (SPARCC), Maastricht Ankylosing Spondylitis Enthesis Score (MASES), Leeds Dactylitis Index (LDI), Patient Global for Psoriatic Arthritis, Dermatology Life Quality Index (DLQI), Psoriatic Arthritis Quality of Life (PsAQOL), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Psoriatic Arthritis Response Criteria (PsARC), Psoriatic Arthritis Joint Activity Index (PsAJAI), Disease Activity in Psoriatic Arthritis (DAPSA), and Composite Psoriatic Disease Activity Index (CPDAI). Arthritis Care Res 2011;63 (Suppl 11):S64–85. 10.1002/acr.20577
    1. Eder L, Thavaneswaran A, Chandran V, et al. . Tumour necrosis factor α blockers are more effective than methotrexate in the inhibition of radiographic joint damage progression among patients with psoriatic arthritis. Ann Rheum Dis 2014;73:1007–11. 10.1136/annrheumdis-2012-202959

Source: PubMed

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