By Shaun Wooller Health Editor For The Daily Mail
Published: 17:00 EDT, 29 July 2024 | Updated: 20:00 EDT, 29 July 2024
Millions of people suffering from osteoarthritis of the knee could benefit from a drug already used to treat autoimmune conditions, a study suggests.
Researchers found methotrexate relieved both the pain and stiffness associated with the disease, in a breakthrough that offers patients ‘real promise’.
Around 5.4 million people in the UK have osteoarthritis of the knee, which occurs when the body can no longer maintain the joint to keep it healthy and pain free.
Current pain relief options are limited, short term and often have minimal benefit.
Surveys carried out by the charity Versus Arthritis show a third of people with osteoarthritis experience severe pain every day.
Around 5.4 million people in the UK have osteoarthritis of the knee, which occurs when the body can no longer maintain 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 not responding to current medications.
Patients were split into two groups with half given a placebo and half given methotrexate in tablet form once weekly over a period of 12 months.
The results, published in the medical journal Annals of Internal Medicine, show those taking methotrexate, experienced less pain and stiffness at 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 demonstrate any benefit, and so people with osteoarthritis have very few options.
‘We are therefore very excited by our findings which show that methotrexate may offer a potential new treatment.
‘Our study demonstrates that a drug already commonly used for rheumatoid arthritis, methotrexate, might help the pain of osteoarthritis, and also gives us a clue about which subset of patients, those with elevated blood inflammation levels, might get benefit from this therapy.’
Exercise, weight management and physiotherapy are the recommended approaches for management of osteoarthritis however the significant levels of pain and stiffness experienced by patients usually necessitates additional therapies such as medication, which are limited.
Joint replacements can be considered for long term relief for those with very advanced osteoarthritis, but NHS waiting lists are often long and people face many years in pain.
Dr Sarah Kingsbury, who also worked on the study, said: ‘Whilst this study offers real promise of a new treatment for osteoarthritis, there are still questions to be answered before methotrexate can be considered for widespread introduction.
‘Our findings suggest that some people may have greater benefit than others from methotrexate, and so our next step is to understand this better, as well as confirming the best dose of methotrexate to use and to consider the cost-effectiveness of methotrexate as a treatment for osteoarthritis.’
Researchers found methotrexate relieved both the pain and stiffness associated with the disease, in a breakthrough that offers patients ‘real promise’
The impact of arthritis can be huge, affecting the ability to work, care for family, move free from 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 breakthrough.
She said: ‘Osteoarthritis research has come far in our lifetime, but we still have a long way to go.
‘New ways to treat osteoarthritis pain are urgently needed, so the results from this study are very exciting.
‘These findings could offer real hope for millions affected by knee osteoarthritis.
‘Against a backdrop 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, hip, and knees.
He said: ‘Osteoarthritis is my main issue – it’s very painful and because I was super fit all my joints are deteriorating.
‘I’ve had trouble with my knees for a while. I was diagnosed with osteoarthritis in my 40s after experiencing pain completing the Great North Run.
‘I was used to do a lot of triathlons, mountain climbing and marathons.
‘Now I’m a bit wonky on my legs even just walking.
‘When you’re at home on your own, if you can’t do things to take your mind off the aches and pains, it’s really hard and affects your mental health.
‘I need better treatments for my osteoarthritis. It’s tough when the painkillers I take don’t make my knees any less painful, as well as my wrists, fingers and toes.
‘There’s millions of us crying out for better medicines that would let us get back to the things we love, so news like this gives people like me real hope for the future’.
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