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Clinical Trial
. 2013 May;52(5):888-92.
doi: 10.1093/rheumatology/kes386. Epub 2013 Jan 7.

Methotrexate for pain relief in knee osteoarthritis: an open-label study

Claire Y J Wenham  1 , Andrew J Grainger, Elizabeth M A Hensor, Anna R Caperon, Zoe R Ash, Philip G Conaghan
Affiliations
Clinical Trial

Methotrexate for pain relief in knee osteoarthritis: an open-label study

Claire Y J Wenham et al. Rheumatology (Oxford). 2013 May.

Abstract

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.

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