Millions of people suffering from knee osteoarthritis could benefit from a drug already used to treat autoimmune diseases, a study suggests.
Researchers have found that methotrexate relieves both pain and stiffness associated with the disease, in a breakthrough that offers “real promise” to patients.
Around 5.4 million people in the UK suffer from knee osteoarthritis, which occurs when the body can no longer support the joint to keep it healthy and pain-free.
Current options for pain relief are limited, short-term, and often have minimal benefit.
Surveys by the charity Versus Arthritis show that a third of people with osteoarthritis experience severe pain every day.
Around 5.4 million people in the UK suffer from knee osteoarthritis, which occurs when the body can no longer support the joint to keep it healthy and pain-free.
Doctors at the University of Leeds and Leeds Teaching Hospitals NHS Trust recruited 155 patients with knee osteoarthritis who were unresponsive to current medications.
The patients were divided into two groups: half received a placebo and half received methotrexate in the form of tablets once a week for a period of 12 months.
The results, published in the Annals of Internal Medicine, show that those taking methotrexate experienced less pain and stiffness after six months.
The drugs work by reducing the activity of the immune system.
Researcher Professor Philip Conaghan said: ‘There is an urgent need for treatments to help relieve the pain of osteoarthritis.
‘Although there have been many trials of potential new treatments, these have largely failed to show any benefit, leaving people with osteoarthritis with very few options.
‘That’s why we are very excited about our findings, which show that methotrexate may offer a potential new treatment.
‘Our study shows that a drug already commonly used for rheumatoid arthritis, methotrexate, could help relieve osteoarthritis pain, and also gives us a clue as to which subset of patients, those with high levels of inflammation in their blood, might benefit from this therapy.’
Exercise, weight control, and physical therapy are the recommended approaches to treating osteoarthritis; however, the significant levels of pain and stiffness experienced by patients usually require additional therapies, such as medications, which are limited.
Joint replacements may be considered for long-term relief for those with very advanced osteoarthritis, but NHS waiting lists are often long and people face many years of pain.
Dr Sarah Kingsbury, who also worked on the study, said: ‘While this study offers real promise for a new treatment for osteoarthritis, there are still questions to be answered before widespread introduction of methotrexate can be considered.
“Our findings suggest that some people may benefit more from methotrexate than others, so our next step is to understand this better, as well as confirm the best dose of methotrexate to use and consider the cost-effectiveness of methotrexate as a treatment for osteoarthritis.”
Researchers have found that methotrexate relieves both pain and stiffness associated with the disease, in a breakthrough that offers patients “real promise”
The impact of arthritis can be enormous, affecting the ability to work, care for family, move without pain and live independently.
Lucy Donaldson, director of research and health intelligence at Versus Arthritis, which funded the research, hailed the trial results as a promising development.
She said: ‘Research into osteoarthritis has come a long way in our lifetime, but we still have a long way to go.
‘New ways to treat osteoarthritis pain are urgently needed, so the results of this study are very exciting.
‘These findings could offer real hope for millions of people affected by knee osteoarthritis.
‘In a context of unacceptably long waiting lists for joint replacements, this study underlines the value of research and why arthritis needs greater prioritisation and investment.’
Military veteran Roger Van-Cauter, 73, from Shropshire, has a number of conditions including osteoarthritis in his hands, hips and knees.
He said: ‘Osteoarthritis is my main problem – it’s very painful and, as I was in very good shape, all my joints are deteriorating.
“I’ve had problems with my knees for a while. I was diagnosed with osteoarthritis at the age of 40 after experiencing pain while completing the Great North Run.
‘I was used to doing a lot of triathlons, mountaineering and marathons.
‘Now my legs are a bit clumsy even when walking.
‘When you’re home alone, if you can’t do things to distract yourself from the aches and pains, it’s really difficult and it affects your mental health.
“I need better treatments for my osteoarthritis. It’s hard when the painkillers I take don’t make my knees, wrists, fingers and toes hurt any less.
“There are millions of us crying out for better medicines that will allow us to do the things we love again, so news like this gives people like me real hope for the future.”