Comparing Methotrexate and TNF Inhibitor Treatment to Prevent Joint Damage in Early Psoriatic Arthritis Using High-Resolution Imaging

What this Trial Is About

Researchers are investigating the effects of two treatments, subcutaneous methotrexate SC MTX and tumor necrosis factor inhibitor TNFi adalimumab biosimilar, on preventing structural damage in people with early, treatment-nafve psoriatic arthritis PsA. This study focuses on evaluating changes in bone erosion and enthesiophyte progression using high-resolution peripheral quantitative computed tomography HR-pQCT over the course of one year. Participants will be randomly assigned in equal numbers to receive either SC MTX or the TNFi adalimumab biosimilar. HR-pQCT scans of the second to fourth metacarpophalangeal joints MCPJ 2-4 will be taken at the start, after 24 weeks, and at one year to assess treatment effects. The primary goal is to compare the change in erosion volume at these joint sites between the two groups after 48 weeks. During the study, participants will undergo imaging assessments at defined intervals to monitor changes in joint structure. Researchers will also measure secondary outcomes, including erosion volume at 24 weeks, healing of erosions, changes in enthesiophyte volume, and progression percentages at weeks 24 and 48. The total study duration includes baseline, mid-point, and one-year assessments, with safety and treatment monitoring throughout.

Preventing Structural Damage in Early Psoriatic Arthritis