Osteoarthritis: A Promising Treatment for Hand Pain With Methotrexate
Osteoarthritis, the most common joint disease, frequently affects the hands. By the age of 85, one in two women and one in four men will experience symptoms of hand osteoarthritis. This condition causes pain and stiffness, hindering daily activities such as dressing and eating, as well as leisure activities. Unfortunately, effective treatments for hand osteoarthritis are scarce. However, a recent study indicates that an affordable medication can alleviate pain in patients suffering from hand osteoarthritis, potentially offering relief.
$10,000 Per Year Medications vs. a $100 Per Year Alternative
Finding an effective treatment has been challenging due to a lack of understanding of the causes of hand osteoarthritis. Previously, it was believed that osteoarthritis resulted solely from age-related “wear and tear,” with inflammation playing an insignificant role. However, recent research has established that inflammation is prevalent in individuals with painful hand osteoarthritis and often leads to joint damage. Pharmaceutical companies sought to determine if their biologic disease-modifying anti-rheumatic drugs, effective in treating other inflammatory joint diseases like rheumatoid arthritis, would be equally beneficial for hand osteoarthritis patients. Unfortunately, these medications failed to demonstrate efficacy for hand osteoarthritis.
In light of this, the study explored the potential of methotrexate, a medication used for treating rheumatoid arthritis since the 1980s, to alleviate hand osteoarthritis. Methotrexate represents an attractive option as it is widely used by doctors, has a proven safety record, and is affordable (approximately $100 per year), making it accessible to a greater number of patients compared to more expensive alternatives costing over $10,000 per year.
Scientific Evidence Supporting Methotrexate Effectiveness
In the trial, participants with hand osteoarthritis and inflammation were divided into groups. One group received a standard oral dose of methotrexate (20mg once a week), while the control group received a placebo. The 97 patients underwent hand X-rays to confirm osteoarthritis and magnetic resonance imaging to detect inflammation. Over a six-month period, pain levels improved in both groups during the initial month, suggesting natural fluctuations. However, the control group experienced no further relief, whereas the methotrexate group continued to experience pain reduction. At three months, the methotrexate group showed improvement, which further increased by the six-month mark. Overall, the methotrexate group experienced twice the pain relief compared to the control group throughout the entire six-month duration.
Further Research and Considerations
Despite the promising results, the study has limitations. Additional research is needed to determine if pain relief continues with longer treatment and if methotrexate can prevent joint damage. Future studies with follow-up X-rays over one to two years can assess joint conditions after treatment. The study also highlights the potential of methotrexate for menopausal women, a population severely affected by hand osteoarthritis.
Conclusion
Based on the study’s findings, doctors can explore the option of prescribing methotrexate to patients with significant hand osteoarthritis symptoms. Methotrexate’s side effects, such as nausea and loss of appetite, are manageable, and more serious issues like liver inflammation and decreased white blood cell count can be detected early through regular blood tests. However, questions regarding the duration and target patient population for methotrexate treatment remain unanswered. Future studies can shed light on these aspects and expand the potential benefits of methotrexate, offering hope to those suffering from hand osteoarthritis.
