What did the research discover?
This study tested whether methotrexate, a drug used to treat rheumatoid arthritis, could help reduce knee pain and stiffness in people with knee osteoarthritis (KOA). Researchers conducted a randomized, double-blind, placebo-controlled trial across 15 clinics in the United Kingdom, including 207 participants with moderate to severe knee pain despite taking their usual pain medications.
Participants were randomly assigned to take either methotrexate (10–25 mg once a week) or a placebo for 12 months, while continuing their usual pain treatment. Researchers measured knee pain, stiffness, and function over time.
After 6 months, the results showed:
- People taking methotrexate had a greater reduction in knee pain compared to those taking a placebo. Pain scores dropped from 6.4 to 5.1 in the methotrexate group, while in the placebo group, pain only dropped from 6.8 to 6.2.
- Methotrexate reduced pain by an average of 0.79 points on a 10-point scale, which was statistically significant.
- People taking methotrexate also had improvements in stiffness and knee function compared to the placebo group.
- Side effects were similar between both groups, and no serious safety concerns were reported.
How can I apply this information?
If you have knee osteoarthritis (KOA) and are not getting enough pain relief from current treatments, this study suggests that methotrexate might be an option to reduce pain, stiffness, and improve function. While the pain relief was modest, it was statistically significant compared to a placebo.
Since methotrexate is already used for inflammatory arthritis, doctors may consider off-label use for osteoarthritis, but more research is needed before it becomes a standard treatment. If you have KOA and are struggling with pain, talk to your doctor to see if methotrexate might be right for you.
Source:
Kingsbury SR, Tharmanathan P, Keding A, Watt FE, Scott DL, Roddy E, Birrell F, Arden NK, Bowes M, Arundel C, Watson M. Pain reduction with oral methotrexate in knee osteoarthritis: a randomized, placebo-controlled clinical trial. Annals of Internal Medicine. 2024 Sep;177(9):1145-56. https://pubmed.ncbi.nlm.nih.gov/39074374/
