Sydney, Oct 15 An affordable existing drug can help provide relief for people with painful hand osteoarthritis, according to a study.
Until now there has been no effective treatment.
Researchers from the Monash University in Australia investigated methotrexate, a low-cost, effective treatment for inflammatory joint conditions such as rheumatoid arthritis and psoriatic arthritis.
They found that methotrexate reduced symptoms in those with hand osteoarthritis (OA).
The double-blind, placebo-controlled trial of 97 people showed that a 20mg weekly oral dose over six months had a moderate effect in reducing pain and stiffness in patients with symptomatic hand OA, revealed their findings published in the journal The Lancet.
Hand OA is a disabling condition that causes pain and affects function, impeding daily activities such as dressing and eating.
It can significantly reduce quality of life. About one in two women and one in four men will experience symptoms from hand OA by the time they turn 85. About half will have inflamed joints, which cause pain and are associated with significant joint damage.
Despite the high prevalence and disease burden, there are no effective medications.
Professor Flavia Cicuttini, who heads Monash University's Musculoskeletal Unit said the study identified the role of inflammation in hand OA and the potential benefit of targeting patients who experience painful hand OA.
"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 said.
"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.
"Based on these results, use of methotrexate can be considered in the management of hand osteoarthritis with an inflammatory pattern. This provides clinicians with a treatment option for this group, which tends to get more joint damage."
Professor Cicuttini said in patients with hand OA and inflammation, the effects of methotrexate were present at about three months and by six months it was very clear if it worked.
"At that time patients and their doctors can decide whether to continue or stop it," she said. "This is very similar to what we currently do with other forms of inflammatory arthritis."
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