Common drug can treat hand osteoarthritis, study finds

An Australian study claims that an existing and affordable drug can drastically improve symptoms of hand osteoarthritis.

Promising results from the study, which was conducted by Monash University and Alfred Health, give hope to individuals suffering from painful hand osteoarthritis (hand OA). Up until now, there has not been an effective treatment for hand OA.

Researchers found regular doses of methotrexate, a drug commonly prescribed for inflammatory conditions, can reduce hand OA symptoms to manageable levels.

What is hand OA?

Hand OA is a debilitating and disabling condition that causes pain and affects function in the hands, impeding daily activities such as dressing and eating. It can significantly reduce quality of life.

It’s also extremely prevalent, with around one in two women and one in four men experiencing symptoms of hand OA by the time they turn 85.

About half of sufferers will have inflamed joints, which cause pain and are associated with significant joint damage.

What is methotrexate?

Methotrexate is an already established, effective treatment for several types of inflammatory diseases, such as Crohn’s disease, severe psoriasis and systemic lupus erythematosus (SLE) as well as both rheumatoid and psoriatic arthritis. In higher doses, it is also used to as a cancer treatment.

It has been widely prescribed in Australia and around the world since the early 1980s and is sold under the brand names Methoblastin, Hospira, Methacord and Trexject.

Now, this new research demonstrates that methotrexate is also effective at reducing the symptoms of hand OA.

In the study, researchers assessed 97 people suffering from hand OA split into two groups, with one group given a weekly dose of 20mg of methotrexate and the other a placebo, over six months.

After an initial period where both groups showed improvement, only the group taking methotrexate showed any lasting reduction in symptoms.

Professor Flavia Cicuttini, lead author of the study, says the results reinforce methotrexate’s reputation for reducing inflammatory conditions.

“In our study, as with most studies of osteoarthritis, both the placebo group and methotrexate groups’ pain improved in the first month or so,” she says.

“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.

“This provides clinicians with a treatment option for this group, which tends to get more joint damage.”

What now?

As the trial ended at six months, Prof. Cicuttini wants to investigate if the positive effects last longer than that, and if methotrexate could potentially be used as a long-term treatment for hand OA.

“Further trials are needed to establish whether the effect of methotrexate extends beyond six months, for how long we need to treat patients, and whether methotrexate reduces joint damage in patients with hand osteoarthritis and associated inflammation,” she says.

She now plans to conduct an extension trial to address these questions, in particular whether older women who develop hand OA around menopause may benefit.

Do you suffer from hand OA? What do you do to relieve symptoms? Let us know in the comments section below.

Also read: Chronic pain relief could be a few clicks away

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