title: Methotrexate for pain relief in knee osteoarthritis: an open-label study.
abstract: OBJECTIVE
  Synovitis is very common in knee OA and associated with pain. This open-label study evaluated an anti-synovitis therapy, MTX, for pain relief in knee OA.
  
  
  METHODS
  Inclusion criteria included pain visual analogue scale (VAS) >40/100 mm, ACR clinical criteria for knee OA and intolerance/inefficacy of NSAID and opioids. US at baseline and 24 weeks assessed effusion and synovial thickness. Patients received MTX up to 20 mg/week for 24 weeks.
  
  
  RESULTS
  Thirty participants were recruited; mean age 64.5 years, median pain VAS 68 mm. At 24 weeks, 13/30 (43%) achieved ≥30% reduction in pain VAS, 7 (23%) achieved ≥50% reduction and 4 (13%) had worsened. Thirteen achieved Osteoarthritis Research Society International (OARSI) responder criteria. All had effusion/synovitis at baseline. There was no correlation between change in imaging and change in pain scores at 24 weeks.
  
  
  CONCLUSIONS
  This open-label trial suggests analgesic efficacy for MTX in OA knee and suggests that a randomized controlled trial is warranted. Trial Registration. Current controlled trials, http://www.controlled-trials.com/, ISRCTN66676866.
authors.affiliation: Division of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, UK.
authors.forename: Claire Y J
authors.initials: CY
authors.lastname: Wenham
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Grainger
authors.forename: Elizabeth M A
authors.initials: EM
authors.lastname: Hensor
authors.forename: Anna R
authors.initials: AR
authors.lastname: Caperon
authors.forename: Zoe R
authors.initials: ZR
authors.lastname: Ash
authors.forename: Philip G
authors.initials: PG
authors.lastname: Conaghan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D010147:Pain Measurement / Q000187:drug effects; D011446:Prospective Studies; D011859:Radiography; D012720:Severity of Illness Index; D013585:Synovitis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D018501:Antirheumatic Agents; D008727:Methotrexate