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Impact of methotrexate and adalimumab on immune function of patients with psoriasis

Patients with psoriasis are commonly treated with methotrexate or biologics. We examined the immune response in a whole blood assay (TruCulture®) to assess the effect of methotrexate and adalimumab. Twenty patients with psoriasis were included and cytokine levels following stimulation with LPS, R848, HKCA, PolyIC, or a blank were investigated before and after 3–6 months of treatment with methotrexate or adalimumab and in patients who had received adalimumab >5 years. Methotrexate only induced minor changes in the cytokine responses, whereas adalimumab affected a wide range of cytokines important for the immune defense towards microorganisms. In the long‐term adalimumab treated group, the cytokine levels were almost equivalent to the short‐term adalimumab‐treated group. Overall, methotrexate was not associated with cytokine suppression. Short and long‐term treatment with adalimumab lowered multiple cytokines involved in the immune defense equally emphasizing the need to continuously be aware of the risk of infections in these patients.