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Access through your institution Buy or subscribe The results of the investigator-initiated phase IIIb MUST trial suggest that there is no added benefit from continuing or initiating
methotrexate (MTX) in patients with psoriatic arthritis (PsA) being treated with the IL-12–IL-23 inhibitor ustekinumab. The study included 173 patients with active PsA from 22 centres in
Germany, stratified according to current MTX use (_n_ = 84) or no previous MTX treatment for PsA (_n_ = 89), who were randomly assigned in a 1:1 ratio to receive open-label ustekinumab plus
masked MTX or placebo. At week 24, mean 28-joint disease activity score based on erythrocyte sedimentation rate was 2.9 in the ustekinumab monotherapy group and 3.1 for patients treated with
ustekinumab plus MTX (between-group difference 0.29; 95% confidence interval 0.13–0.71), indicating non-inferiority of the monotherapy compared with the combination therapy. No additional
effect of MTX was seen on the other outcomes evaluated, including joint counts, psoriasis, dactylitis, enthesitis, patient-reported outcomes, treatment retention and immunogenicity. This is
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* Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support REFERENCES ORIGINAL ARTICLE * Koehm, M. et al. Methotrexate plus ustekinumab versus ustekinumab
monotherapy in patients with active psoriatic arthritis (MUST): a randomised, multicentre, placebo-controlled, phase 3b, non-inferiority trial. _Lancet Rheumatol._ 5, e14–e23 (2023) Article
CAS Google Scholar Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Nature Reviews Rheumatology http://www.nature.com/nrrheum/ Sarah Onuora Authors * Sarah Onuora View
author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to Sarah Onuora. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT
THIS ARTICLE CITE THIS ARTICLE Onuora, S. No benefit from adding MTX to ustekinumab. _Nat Rev Rheumatol_ 19, 129 (2023). https://doi.org/10.1038/s41584-023-00912-w Download citation *
Published: 30 January 2023 * Issue Date: March 2023 * DOI: https://doi.org/10.1038/s41584-023-00912-w SHARE THIS ARTICLE Anyone you share the following link with will be able to read this
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