Common drug – methotrexate – can improve hand arthritis symptoms

Relief may be on the way for people with painful hand osteoarthritis after a study published in The Lancet found an affordable existing drug called methotrexate could take on pain and stiffness.
Hand osteoarthritis impedes daily activities such as eating and dressing. About half of women and one-quarter of men are affected by the time they turn 85 years old. There are currently no effective medications.

Already used for inflammatory joint conditions including rheumatoid arthritis and psoriatic arthritis, a 20mg weekly oral dose of methotrexate over six months was found to reduce pain and stiffness in people with hand osteoarthritis. Almost 100 people were involved in the trial.

“In our study, as with most studies of osteoarthritis, both the placebo group and methotrexate groups’ pain improved in the first month or so,” Prof Flavia Cicuttini explains. “However, pain levels stayed the same in the placebo group but continued to decrease in the methotrexate group at three and six months, when they were still decreasing. The pain improvement in the methotrexate group was twice as much as in the placebo group.”

Like many drugs, methotrexate can have some side effects so these need to be weighed up against potential benefits. But it’s great to have a new option, the team points out:

“Based on these results, use of methotrexate can be considered in the management of hand osteoarthritis with an inflammatory pattern.”

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