New trial to bring hope for people with knee osteoarthritis
Published on 30 September 2013
University of Leeds researchers are to carry out a major new Arthritis Research UK-funded clinical trial that could bring relief to the six million people in the UK with the potentially crippling condition of osteoarthritis of the knee.
The announcement of the new study comes in advance of National Arthritis Week (October 7-13) set up to increase awareness of the devastating effect of arthritis on 1 in 6 people in the UK.
Professor Philip Conaghan, a leading authority on musculoskeletal conditions, has been awarded £1.2m by the Chesterfield-based medical research charity to run a multi-centre clinical trial, which aims to test the effectiveness of a drug called methotrexate in relieving the pain of knee osteoarthritis.
Methotrexate is already successfully and widely used to treat people with the condition of rheumatoid arthritis, a completely different condition to osteoarthritis. 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. He and colleagues have already performed a pilot study which showed that 37% of patients with knee osteoarthritis who took methotrexate had a 40% reduction in their pain.
“Current drug treatments for knee osteoarthritis are limited in that they have significant side-effects and are not suitable for many people,” explained Professor Conaghan. “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 such as painkillers, 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 number of people affected by osteoarthritis has increased 2-4 fold 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. But there remains an acknowledged treatment gap, and more effective forms of pain relief are urgently needed.
Professor Conaghan is also running an Arthritis Research UK-funded trial testing the effectiveness of another drug commonly used to treat rheumatoid arthritis called hydroxychloroquine, on osteoarthritis of the hand.
Arthritis Research UK receives no government funding and is the only charity in the UK dedicated to funding research into finding the cause, new treatments and cure for all forms of arthritis.
In National Arthritis Week Arthritis Research UK is appealing to the public in order to continue funding its vital work. People can help making a Joint Effort pledge during the week: either by supporting the charity’s work by raising money, by sharing their experiences of arthritis in a National Arthritis Survey or by finding out more about the realities of living with arthritis.