A medication used for autoimmune conditions has been found to be effective in relieving the pain and stiffness caused by knee osteoarthritis, a condition that affects 5.4 million people in the UK and 364 million globally.
The discovery has come from a research team from the University of Leeds and Leeds Teaching Hospitals NHS Trust (LTHT), and funded by charity Versus Arthritis.
The charity has said the breakthrough could offer hope for millions of people across the UK suffering with chronic pain and stiffness caused by osteoarthritis of the knee.
The results of the clinical trial show methotrexate, a medication already used for autoimmune conditions, to be effective in relieving both the pain and stiffness caused by knee osteoarthritis.
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Current pain relief options for knee osteoarthritis are limited, short term and often have minimal benefit. According to surveys carried out by Versus Arthritis, a third of people with osteoarthritis said they experienced severe pain every day.
If these survey results are representative of the UK population, it means millions of people are living with debilitating pain because of their osteoarthritis every single day of their lives, the charity has said.
The research, published in the journal Annals of Internal Medicine, was led by Professor Philip Conaghan and Dr Sarah Kingsbury of the Leeds NIHR Biomedical Research Centre in Leeds, hosted by LTHT in partnership with the University of Leeds.
Professor 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, he added.
Working with 15 hospitals across the UK, the team 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 showed those taking methotrexate, which reduces the activity of the immune system, experienced less pain and stiffness at six months.
Dr Kingsbury added that further research would now be required. 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, she said.
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, she added.
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