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Pain Reduction With Oral Methotrexate in Knee Osteoarthritis : A Randomized, Placebo-Controlled Clinical Trial
Sarah R Kingsbury1, Puvan Tharmanathan2, Ada Keding2
1Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and National Institute for Health and Care Research (NIHR) Leeds Biomedical Research Centre, Leeds, United Kingdom (S.R.K., P.G.C.).
Annals of Internal Medicine
|July 29, 2024
Summary
Methotrexate significantly reduced knee osteoarthritis pain and stiffness in a 12-month trial. This study suggests oral methotrexate is a viable treatment option for knee osteoarthritis (KOA) patients.
Area of Science:
- Rheumatology
- Pharmacology
- Clinical Trials
Background:
- Osteoarthritis (OA) treatments are limited.
- Methotrexate, an antirheumatic drug, shows potential for OA pain relief in preliminary studies.
Purpose of the Study:
- To evaluate the symptomatic benefits of methotrexate in patients with knee osteoarthritis (KOA).
Main Methods:
- A 12-month, multicenter, randomized, double-blind, placebo-controlled trial involving 155 participants with symptomatic KOA.
- Participants received either oral methotrexate (10-25 mg weekly) or placebo, alongside usual analgesia.
Main Results:
- Methotrexate demonstrated a statistically significant reduction in knee pain (0.79 NRS points, P=0.030) at 6 months compared to placebo.
- Significant improvements were also observed in knee stiffness and function (P=0.045 and P=0.008, respectively) with methotrexate treatment.
Conclusions:
- Oral methotrexate, when added to usual medications, significantly reduces pain, stiffness, and improves function in patients with knee osteoarthritis at 6 months.
- The study supports methotrexate as a beneficial treatment for symptomatic knee OA.
