Thirty-five patients with Early
Psoriatic Arthritis (EPA) (17 female and 18 male; mean age 25.6 years) entered this randomised 6-month study. At the enrolment, all patients were on non-steroidal anti-inflammatory
drug (
NSAID)
therapy on demand and were divided in two matched groups (A and B). Group A continued
NSAID therapy at full dosage in the following 3 months and then added
methotrexate (MTX) for another 3 months. Group B was under the combination of
NSAID and MTX for the entire 6-month period. Clinical and laboratory assessment included the count of tender joints and/or entheses (TJC), the count of swollen joints and/or entheses (SJC), patient's global assessment (
PGA), physician's global assessment (
PhGA), patient's assessment of
pain (VAS), erythrocyte sedimentation rate (ESR) and serum concentration of
C-reactive protein (CRP). All variables were done at baseline (T0), at 3 (T3) and at 6 months (T6). In both group A and in group B, there was a significant improvement of all variables at T3 and T6. However, in comparison to the patients of group A, patients included in group B showed a more rapid and marked improvement of TJC and SJC, which was statistically significant at T3 (p < 0.05). In contrast, the improvement of
PGA,
PhGA, VAS, ESR and CRP was not significantly different between groups. The early use of MTX in EPA patients markedly improves TJC and SJC. In fact, at T3, other markers used to quantify EPA disease activity, in particular
PGA,
PhGA, VAS, ESR and CRP, did not show significant differences in EPA patients treated with either
NSAIDs or MTX. This finding suggests an incomplete control under MTX of the pathogenetic process and stimulates further interest on early use of other therapeutical approaches capable of modifying the course of disease.