Drug trial raises hopes

It is five years since Susan Dawson started to suffer from osteoarthritis.

She started with pain in her knees, which eventually resulted in one of her knees giving way. X-rays revealed she was suffering from osteoarthritis. She was prescribed anti-inflammatory drugs and also had steroid injections but nothing seemed to work.

“The swelling in my knees was terrible and I was in agony,” explains the 57-year-old from Liversedge.

In the end she was forced to take time off from her job as a school’s learning mentor and lunchtime manager.

She was eventually offered a drug that was being trialled at Leeds Teaching Hospitals as part of a pilot study by Professor Philip Conaghan

Methotrexate is already successfully and widely used to treat people with the condition of rheumatoid arthritis, a completely different condition. Both conditions can lead to severe joint pain and stiffness but while rheumatoid arthritis is a serious autoimmune condition that causes inflammation in the joints, osteoarthritis is a degenerative joint disease in which cartilage wears away at the ends of bones.

However, according to Professor Conaghan, from the Leeds Institute of Rheumatology and Musculoskeletal Medicine based at Chapel Allerton Hospital, recent studies have suggested that inflammation is also important in causing pain in osteoarthritis.

The pilot study, which involved Susan, showed that 37 per cent of patients with knee osteoarthritis who took methotrexate had a 40 per cent reduction in their pain.

“It took about three months before I noticed any difference,” Susan says.

“But then the swelling started to go down 
and the pain became a 
lot better.”

Susan was on methotrexate for about 18 months, although she is no longer on it.

“It seems to have done the trick but if my knees swell up again I will definitely want to start taking it again.”

Now Prof Conaghan and his team have been given funding from Arthritis Research UK to extend his trial, which could bring relief to the six million people in the UK with the potentially crippling condition of osteoarthritis of the knee.

“Current drug treatments for knee osteoarthritis are limited in that they have significant side-effects and are not suitable for many people,” he explained. “As a result, people with osteoarthritis often live with severe pain and have significant difficulty in carrying out their normal day-to-day activities. There is therefore an urgent need to find new and better ways of managing their pain.”

Up to 160 people with moderate to severe osteoarthritis of the knee from 15 centres around the UK, who are not getting benefit from traditional treatments, will be recruited onto the trial from early 2014. Half of those recruited will take methotrexate for 12 months and the other half will take a placebo tablet. All patients will have a magnetic resonance image (MRI) taken of their knee, and fill in questionnaires every three months.

The agony of Osteoarthritis

The number of people affected by osteoarthritis has increased 2-4 times over the past 50 years as the population ages and becomes more obese – two major risk factors for developing osteoarthritis. The condition accounts for more than a third of chronic moderate to severe pain in the UK. Painkillers, muscle-strengthening exercise, and weight loss can all help to manage the condition, while joint replacement surgery can be extremely effective for people with severe, end-stage osteoarthritis.

For more on the trial contact Sarah Hogg on 0113 392 4990 or [email protected]