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Orally administered Methotrexate remarkably improves pain, stiffness, and function in knee osteoarthritis-affected patients.
In a large-scale, randomized clinical trial conducted across 15 musculoskeletal clinics in United Kingdom, oral Methotrexate delivered substantial relief from knee osteoarthritis (OA) pain, stiffness, and also improved function within just 6 months. The study, involving 207 volunteers, was designed to assess the symptomatic benefits of Methotrexate as a potential treatment for knee OA.
Patients suffering from symptomatic, radiographic knee OA and frequent knee pain (severity ≥4/10) over the past 3 months, unresponsive to current medications, were enrolled. The recruited subjects were randomly assigned in a 1:1 ratio to get either oral Methotrexate (10–25 mg weekly, with a 6-week escalation) or a matched placebo over 12 months, while continuing their usual analgesic treatment. Average knee pain was the key outcome ascertained.
It was measured on a numerical rating scale (NRS) from 0 to 10, at 6 months. A 12-month follow-up was executed to determine long-term response. Knee stiffness, function outcomes, and the occurrence of adverse events were the secondary outcomes ascertained. Results indicated that after 6 months of treatment, those who received Methotrexate reported a noticeable reduction in knee pain, with a 0.79-point greater decrease on a 10-point scale when compared to those receiving a placebo (Table 1).
In addition to pain alleviation, volunteers in the Methotrexate group also experienced improvements in knee stiffness (0.60 points) and function (5.01 points), as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), with significant differences in favor of Methotrexate. The treatment adherence analysis revealed a dose-response effect, further supporting the potential benefits of Methotrexate. The treatment was well-tolerated, with 4 unrelated serious adverse events reported (2 in the Methotrexate group and 2 in the placebo group). These encouraging findings suggest that oral Methotrexate, when added to usual medications, is a useful intervention for ameliorating knee OA pain, patient mobility, and quality of life.
Annals of Internal Medicine
Pain Reduction With Oral Methotrexate in Knee Osteoarthritis: A Randomized, Placebo-Controlled Clinical Trial
Sarah R Kingsbury et al.
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