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Updated: May 15, 2026
Fu's Subcutaneous Needling for Knee Osteoarthritis Pain
Published on: March 24, 2023
Methotrexate for pain relief in knee osteoarthritis: an open-label study
Claire Y J Wenham1, Andrew J Grainger, Elizabeth M A Hensor
1Division of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, UK.
Objective:
Synovitis is very common in knee OA and associated with pain. This open-label study evaluated an anti-synovitis therapy, MTX, for pain relief in knee OA.
Methods:
Inclusion criteria included pain visual analogue scale (VAS) >40/100 mm, ACR clinical criteria for knee OA and intolerance/inefficacy of NSAID and opioids. US at baseline and 24 weeks assessed effusion and synovial thickness. Patients received MTX up to 20 mg/week for 24 weeks.
Results:
Thirty participants were recruited; mean age 64.5 years, median pain VAS 68 mm. At 24 weeks, 13/30 (43%) achieved ≥30% reduction in pain VAS, 7 (23%) achieved ≥50% reduction and 4 (13%) had worsened. Thirteen achieved Osteoarthritis Research Society International (OARSI) responder criteria. All had effusion/synovitis at baseline. There was no correlation between change in imaging and change in pain scores at 24 weeks.
Conclusion:
This open-label trial suggests analgesic efficacy for MTX in OA knee and suggests that a randomized controlled trial is warranted. Trial Registration. Current controlled trials, http://www.controlled-trials.com/, ISRCTN66676866.
