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We read with interest the Letter to the Editor by Kerschbaumer et al regarding our article on the primary results from the SEAM-PsA trial (1). We appreciated the comments highlighting the methotrexate (MTX) monotherapy results. Since MTX is a drug that has been long used in psoriatic arthritis (PsA) without much data from rigorous and well-controlled clinical trials, we sought to provide reliable data about MTX through SEAM-PsA. This article is protected by copyright. All rights reserved.A large number of reactive oxygen species (ROS)