Trial results for the SPEED Trial (NCT03739853) investigating early intervention strategies for Psoriatic Arthritis, including adalimumab as part of an early TNF inhibition arm, were posted on ClinicalTrials.gov on 2025-11-26. The study indicated that early TNF inhibition led to lower Psoriatic Arthritis Disease Activity Scores (PASDAS) compared to standard care.
Background
The Severe Psoriatic Arthritis - Early intervEntion to Control Disease (SPEED) Trial aimed to evaluate more aggressive early therapy in patients newly diagnosed with moderate to severe Psoriatic Arthritis, comparing standard step-up therapy against early combination csDMARDs and early TNF inhibitor therapy.
Trial design
The SPEED Trial (NCT03739853) was a Phase 4, three-arm interventional study nested within a cohort, enrolling 192 participants with Psoriatic Arthritis. Interventions included standard step-up therapy, early combination csDMARDs (methotrexate, sulfasalazine, leflunomide), and early TNF inhibitor therapy (adalimumab).
Key results
The trial evaluated Psoriatic Arthritis Disease Activity Score (PASDAS) and Minimal Disease Activity (MDA) across the three intervention arms. For the outcome of "Psoriatic Arthritis Disease Activity Score (PASDAS)":
- The Standard Care group reported mean PASDAS scores of 4.7 (Standard Deviation: 1.5) and 4.1 (Standard Deviation: 1.8) on a scale.
- The Combination csDMARD group reported mean PASDAS scores of 4.0 (Standard Deviation: 1.5) and 3.8 (Standard Deviation: 1.5) on a scale.
- The Early TNF Inhibition group reported mean PASDAS scores of 3.6 (Standard Deviation: 1.9) and 3.5 (Standard Deviation: 1.7) on a scale.
For the outcome of "Minimal Disease Activity (MDA)", measured by the count of participants achieving this state:
- In the Standard Care group, 44 and 38 participants achieved MDA.
- In the Combination csDMARD group, 40 and 36 participants achieved MDA.
- In the Early TNF Inhibition group, 42 and 36 participants achieved MDA.
What this means
The SPEED Trial results suggest that early TNF inhibition with drugs like adalimumab may lead to lower disease activity in newly diagnosed moderate to severe Psoriatic Arthritis patients compared to standard care. The consistently lower mean PASDAS scores indicate a potential benefit in controlling disease progression, offering valuable insights for initial treatment approaches.
Source
The information regarding these trial results was obtained from ClinicalTrials.gov, a public database of clinical studies. The results for study NCT03739853, titled "Severe Psoriatic Arthritis - Early intervEntion to Control Disease: the SPEED Trial," were posted on 2025-11-26 on clinicaltrials.gov.