New use of Methotrexate for Osteoarthritis, not just RA

Stigger

Interesting new pilot from University of Leeds; hopefully seems to be a new, effective treatment for OA as well as RA.
http://www.dailymail.co.uk/health/article-2487353/The-pill-arthritis-sufferers-moving-A-radical-surprising-new-option-patients-crippled-painful-joints.html

brandy192

This is very interesting because I was given steroids recently for a chest infection and my knees have never felt so good.I still got the clicking but the stiffness and pain disappeared. I just wonder if this drug would be suitable for people who had things like COPD as it decreases the immune system they would be more prone to infection. It sounds quite promising for osteo sufferers though. I would be more than willing to try methotrexate but most GPs seem to be happy to dish out the same old painkillers without much sympathy.

barbara12

Thanks for the link stigger, I sometimes feel OA is not taken seriously enough..it would be good to have some relief from it all

emsjane

I have a diagnosis of Seronegitive Arthritis and my Rheumatologist has put me on Methotrexate. I can't honestly say I've noticed any drastic improvements sadly, as my arthritis just seems to be getting worse and worse.

In fact I'm noticing I get out of breath more quickly since being on it and I just don't feel myself on it. Also, I got a cyst in my calf and that went and now I think I have another one and I read on the side effects about calf pain and swelling so now I'm wondering if the MTX has caused these! I'm going for another calf scan Monday so I'm going to ask!

Its a very powerful drug and one that I'm not entirely happy being on. But I have to acknowledge that my arthritis is getting worse and I need to try something!

Rheumy suggested I try Sulfasalazine. Is anyone on this and has it helped and what are the side effects?

Boomer13

Hi emsjane;
I have seronegative arthritis (PsA with spondyloarthropathy). I've been on mtx and hydroxychloroquine for 10 mths, and was put on prednisone 4 mths ago because mtx is only working partially. I had a dose increase two weeks ago and added Sulfasalazine 3 weeks ago, and started tapering off prednisone. I am in a mild peripheral joint flare presently and think it's too early to say whether sulfa. is working.

The side-effects since starting sulfa. have been not very pleasant: initially affected my GI tract with pain, etc, then, sore throat and sinus pain, swollen face. All somewhat better except the sore throat and sinus. Now I'm have headaches, some very severe. It's not very nice so far and I'm really hoping I get used to it soon.

Rheum wants to put me on anti-TNF's possibly in January. It's difficult to know how much better I should feel, so I'm having a tough time at the moment with all this waiting and seeing.

Take care, I hope you have good luck with Sulfa, and minimal side-effects.
xxAnna

PS it would be great if methotrexate turns out to benefit OA, I know a lot of people who would welcome a new treatment.

Mat48

I had read about this use of Methotrexate for OA sufferers a few months ago too and wondered how this might work. While I personally have struggled as much with the drugs as I have with the RA - I'm glad that I at least have the option to try drugs that may halt the progress of the disease.

I have been told that I have degeneration of my L5 and some early OA in my hands as well. The stiffness and pain in hips/ groin that this OA causes has been quite an issue for me at times and seems to improve hugely when I've been on higher doses of injectable Methotrexate and while on Prednisolone. This could just be coincidence as my rheumy suggests, but I don't think so.

It would be great if there were similar options for people with aggressive OA too - although personally I wouldn't want to take these drugs unless things were pretty bad. Mat x

dreamdaisy

I have a creaky foot in both camps and can honestly say, hand-on-heart, that the meth I take on a weekly basis does not touch the OA in any way shape or form. The diclos do, and the co-cos help to soften the sharper edges of the pain, but the meth? Not a sausage. It could be that if one only has OA then it could be of benefit but we are all different in what helps and doesn't. DD

Mat48

I agree that each of us will respond differently to medications so there's no one rule fits all. I suppose it could also mean that for some, what has been assumed to be OA by doctors, might actually turn out to be an inflammatory autoimmune type of arthritis - perhaps diagnosed wrongly as OA when it may have been or become a type of sero negative RA or Spondyloarthritis? Rheumatology is a very inexact area of science so this could explain the new thinking re Methotrexate for OA too?

Starburst

I have to say, I find it quite strange. In layman's terms, RA (and other inflammatory types of arthritis) are the immune system being overactive and mistakenly attacking the joints. So, MTX dampens down the immune system to stop it attacking the joints, why would it work for OA unless the OA has been misdiagnosed, as Mat says? I have some OA and the RA treatments make no different at all to my OA joints.

I'd be concerned about taking MTX for OA unless there was clear, established evidence given its side effects and the risks.

Stigger

OA has considerable inflammtion too and as both conditions can lead to inflammation - pain, swelling and stiffness - in the joints. The thinking behind the pilot study was that if methotrexate works in reducing inflammation, it would help osteoarthritis, too.

Every drug has side effects, some worse than others. Most people with OA are on high doses of anti-inflammatories e.g. Diclofenac which have serious long term effects on the digestive system and have to be countered with other drugs e.g. Omniprazole.

There is no 'cure' for either condition but if something that suits one can also help with the other, it's surely worth exploring. Anything that relieves the pain of OA, through reducing inflammation is worth exploring.

Boomer13

That was my understanding too, Stigger. Methotrexate has anti-inflammatory effects and reduces inflammation which is how it may work in OA. Similar to prednisone in that way, I guess. It's use in OA may be for the anti-inflammatory effect, not the immune system effect, as it's used in autoimmune arthritis.

dreamdaisy

I am on a triple therapy for my PsA and the usual standard measures of inflammation (in my case ESR and CPR) are always below 5 and very often too small to be measured. And yet . . . . a daily diclo (only taken after an omep and then food) means that my knees, ankles and right hip feel easier and I can wear my original wedding ring.

I am not a doc but I do wonder if different kinds of inflammation could be involved? :? I reckon the human body is weird in what it can (and cannot) do. I think mine is just plain weird. DD

Mat48

What surprises me somehow is that autoimmune arthritis is grouped under the heading of muscoskelital conditions in policy terms rather than autoimmune conditions? To me this sounds so dry and bony compared to the way I am affected by RA somehow? I know that some people do have arthritis as a muscoskeletal problem principally, but for me everything is so systemic and its the autoimmune heading where I feel (unfortunately) I belong.

If I bump into my friends with Crohns and Lupus and Schloedemer and even MS I seem to have lots in common compared to friends with OA. So perhaps if the many people with OA I know are taking the same drugs as those of us with autoimmune diseases we will be able to relate to each other more easily again? But presently I always feel I need to stay quiet when I'm out with my OA pals because they have all the drama of hips and other large parts going wrong and far more specific pain - whereas I just feel achy and flu-like and inexplicably exhausted with puffy sore tendons and weird tingling and numbness. But in terms of real pain - perhaps only one excruciating little toe or finger?

So I would love to see these friends with OA find some relief and no longer have to sit and listen to their talk of body mechanics issues and feel vaguely fraudulent and guilty?