People suffering from painful hand osteoarthritis may find relief through an affordable existing drug, according to a study led by Monash University and Alfred Health. The research, published in The Lancet, focused on methotrexate, a low-cost and effective treatment for inflammatory joint conditions like rheumatoid arthritis and psoriatic arthritis.
The study found that a 20mg weekly oral dose of methotrexate over six months had a moderate effect in reducing pain and stiffness in patients with symptomatic hand osteoarthritis. Hand osteoarthritis is a debilitating condition that causes pain and impeding daily activities. Despite its prevalence, there has been no effective medication until now. The study identified the role of inflammation in hand osteoarthritis and the potential benefits of targeting patients who experience painful hand osteoarthritis.
Senior author Professor Flavia Cicuttini explained that while the placebo group and methotrexate groups’ pain improved in the first month, the pain levels stayed the same in the placebo group while decreasing in the methotrexate group at three and six months. The pain improvement in the methotrexate group was twice as much as in the placebo group. Professor Cicuttini said that in patients with hand osteoarthritis and inflammation, the effects of methotrexate were present at about three months, and by six months, it was clear if it worked.
Further trials are needed to establish whether the effect of methotrexate extends beyond six months and whether it reduces joint damage in patients with hand osteoarthritis and associated inflammation. Professor Cicuttini plans to conduct an extension trial to address these questions, particularly whether women who develop hand osteoarthritis around menopause may benefit from methotrexate.
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