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Intra-articular methotrexate in knee synovitis.

N Hasso1, P J Maddison, A Breslin

  • 1Department of Rheumatology, Ysbyty Gwynedd, Bangor, Wales, UK.

Rheumatology (Oxford, England)
|April 1, 2004
PubMed
Summary
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Adding methotrexate to intra-articular corticosteroids did not significantly improve outcomes for chronic knee synovitis. This study found no added benefit in pain, swelling, or stiffness when methotrexate was combined with triamcinolone hexacetonide.

Area of Science:

  • Rheumatology
  • Pharmacology

Background:

  • Chronic knee synovitis is a persistent inflammatory condition.
  • Intra-articular corticosteroids are a common treatment for knee synovitis.
  • Methotrexate is an immunosuppressive drug used in various inflammatory conditions.

Purpose of the Study:

  • To evaluate if adding methotrexate to intra-articular corticosteroid injections enhances the suppression of knee synovitis.
  • To determine if methotrexate prolongs the therapeutic effects of intra-articular corticosteroids.

Main Methods:

  • A randomized controlled trial involving 38 patients with chronic knee synovitis.
  • Patients received intra-articular triamcinolone hexacetonide with or without methotrexate.
  • Assessed outcomes included knee pain, swelling, global assessments, morning stiffness, ESR, and CRP, with a primary endpoint of improvement duration.

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Main Results:

  • Both treatment groups showed significant improvement in all assessed variables post-treatment.
  • No statistically significant difference was observed in the degree or duration of clinical response between the groups.
  • Methotrexate was generally well-tolerated, with only minor transaminase elevations noted in some patients.

Conclusions:

  • The addition of methotrexate to intra-articular triamcinolone hexacetonide did not provide significant additional clinical benefit for chronic knee synovitis in this study.
  • Further research with different study designs may be warranted to explore potential benefits of methotrexate in this context.