July 19, 2024

New Treatment Option Discovered for Hand Osteoarthritis

A recent study led by Monash University and Alfred Health has identified a potential treatment option for individuals suffering from hand osteoarthritis (OA). Until now, there has been no effective treatment available for this condition, which causes pain and impairs daily activities such as dressing and eating. The study, published in The Lancet, explored the use of methotrexate, an affordable drug that has been widely used since the 1980s to treat inflammatory joint conditions like rheumatoid arthritis and psoriatic arthritis.

The researchers found that a weekly oral dose of 20mg of methotrexate over a period of six months yielded positive results in reducing pain and stiffness in patients with symptomatic hand OA. Hand OA affects a significant number of individuals, with approximately one in two women and one in four men experiencing symptoms by the age of 85. In some cases, the condition leads to inflamed joints and significant joint damage, causing even more pain and impairment.

Senior author Professor Flavia Cicuttini, who heads Monash University’s Musculoskeletal Unit and serves as The Alfred’s Head of Rheumatology, emphasized the importance of targeting patients experiencing painful hand OA and inflammation. In the study, pain levels improved in both the placebo group and the methotrexate group initially, but the improvement continued in the methotrexate group at three and six months. The methotrexate group showed twice as much improvement in pain compared to the placebo group.

These findings suggest that methotrexate could be considered as a treatment option for patients with hand OA and an inflammatory pattern. This provides clinicians with an effective option for managing this subgroup of patients, who are more prone to experiencing joint damage. The study also revealed that the effects of methotrexate can be observed at around three months and become more evident by six months.

The trial, funded by the National Health and Medical Research Council (NHMRC), involved 97 participants with symptomatic hand OA and synovitis (inflammation). The effects of a weekly dose of 20mg methotrexate were compared to a placebo over a six-month period. Participants were recruited from various cities in Australia, including Melbourne, Hobart, Adelaide, and Perth.

Professor Cicuttini highlighted the need for further research to investigate the long-term effects of methotrexate beyond six months and its potential to reduce joint damage in hand OA patients with inflammation. She plans to conduct an extension trial to address these questions, particularly focusing on women who develop hand OA around menopause, as they often experience severe pain and joint damage.

These findings offer hope for individuals suffering from hand OA, providing a potential solution to manage inflammation and alleviate pain. With further research, methotrexate could prove to be a game-changer in the treatment of this disabling condition.

1. Source: Coherent Market Insights, Public sources, Desk research
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