Intra-articular methotrexate in knee synovitis.
OBJECTIVE
To test whether methotrexate prolongs the effect of intra-articular corticosteroid in suppressing knee synovitis.


METHODS
Thirty-eight patients with chronic knee synovitis were randomly allocated to receive intra-articular triamcinolone hexacetonide with or without methotrexate. Variables were knee pain and swelling, assessor and patient global assessment, morning stiffness, ESR and CRP. The primary endpoint was the duration of improvement.


RESULTS
After treatment, both groups of patients demonstrated a significant improvement in all variables. However, there was no significant difference between the two groups in the degree or duration of the response. No side-effects were encountered with methotrexate apart from a slight elevation of transaminase levels in some patients.


CONCLUSIONS
In the context of this study, the addition of methotrexate to triamcinolone did not add significantly to the clinical response to intra-articular corticosteroid in chronic knee synovitis. However, further controlled studies using different designs are probably warranted.
Hasso
N
N
Department of Rheumatology, Ysbyty Gwynedd, Bangor, Wales, UK.
Maddison
P J
PJ
Breslin
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D013585:Synovitis / Q000188:drug therapy*; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D018501:Antirheumatic Agents; D014222:Triamcinolone Acetonide; C005900:triamcinolone hexacetonide; D008727:Methotrexate