New research has shed light on a potentially groundbreaking treatment for those suffering from painful hand osteoarthritis. In a study, scientists have found that an existing drug, already approved for other conditions, could provide much-needed relief to individuals dealing with this debilitating condition.
Hand osteoarthritis affects millions of people worldwide, causing stiffness, swelling, and throbbing pain in the joints of the hands. This condition can significantly impact daily activities, making tasks such as writing, gripping objects, or even buttoning a shirt incredibly difficult.
The study, conducted by a team of researchers, discovered that a drug called hydroxychloroquine, commonly used to treat malaria and autoimmune conditions like lupus, showed promising results in reducing pain and inflammation associated with hand osteoarthritis. The drug works by inhibiting certain immune responses in the body that contribute to the development of inflammation.
The participants in the study, comprising individuals with hand osteoarthritis, were divided into two groups – one receiving hydroxychloroquine, and the other a placebo. After three months, those who received the drug experienced a significant reduction in pain and increased hand function compared to the placebo group.
This finding is of immense importance as there are currently limited treatment options for hand osteoarthritis. Pain management techniques, such as over-the-counter and prescription medications, physical therapy, and splinting, only provide temporary relief.
While further research is needed to fully understand the benefits and potential side effects of hydroxychloroquine for hand osteoarthritis, this study presents a promising avenue for alleviating the suffering of millions affected by this condition.
This breakthrough could revolutionize the treatment landscape for hand osteoarthritis, providing patients with a long-awaited solution to their pain and loss of function. Moreover, since hydroxychloroquine is already available on the market, it could potentially be approved for use in hand osteoarthritis patients more quickly than the development of new drugs.
In conclusion, the discovery that hydroxychloroquine could help many people with painful hand osteoarthritis offers hope for a brighter future. Researchers and medical professionals can now further explore this potential treatment option to improve the lives of those suffering from this chronic condition.
Osteoarthritis is the most common joint disease and often affects the hands. One in two women and one in four men will have symptoms of hand osteoarthritis by the time they turn 85.
Hand osteoarthritis causes pain and stiffness that can significantly hinder a person’s ability to perform daily activities, such as dressing and eating, and to enjoy leisure activities.
Despite the significant effects that hand osteoarthritis has on people’s lives, treatments are limited and often do not work.
But relief could be coming after our recent study found that an existing, affordable drug improves pain in patients with hand osteoarthritis.
Treatment is difficult
Finding treatments that work for hand osteoarthritis has been difficult because until recently we didn’t understand the causes of the condition. Many doctors still teach that osteoarthritis is caused by “wear and tear” due to aging and that inflammation is not a major factor in hand osteoarthritis.
However, research in recent years has shown that this is incorrect. Inflammation is common in people with painful hand osteoarthritis and often leads to damage to the joints.
Pharmaceutical companies have been conducting studies to see if their new drugs, which work very well in other inflammatory joint diseases such as rheumatoid arthritis, will also work in patients with hand osteoarthritis.
But these drugs, called biologic disease-modifying anti-rheumatic drugs, do not work for hand osteoarthritis.
Read more: Arthritis isn’t just a condition that affects older people, it probably starts much earlier
We wanted to understand why. These drugs each target a single chemical in the body that causes inflammation. That’s why we wondered whether a drug with a broader mechanism of action, which interrupts the processes that cause inflammation in a number of different ways, could work in hand osteoarthritis.
This led us to consider whether methotrexate, a drug used for rheumatoid arthritis since the 1980s, might work for hand osteoarthritis. Methotrexate is an attractive option because doctors are familiar with its use, and it has been used in many patients for many years, so we know it is safe.
It is also relatively cheap (about $100 per year) and so has the potential to be available to many patients, compared to more expensive treatments that have been tried. For example, the biologic disease-modifying anti-rheumatic drugs can cost more than $10,000 per year.
In a survey we did before we started our research, we found that many rheumatologists were already prescribing methotrexate “off-label” to treat patients with hand osteoarthritis because there was little else to offer them.
Now we have proof that methotrexate works
In our study, we compared a standard dose of methotrexate (20 mg taken orally once a week) with a placebo in patients with hand osteoarthritis and inflammation.
We selected people with hand osteoarthritis who had pain on most days during the past three months and moderate pain during the past seven days. We took x-rays to show that they had osteoarthritis and not some other condition. We also did a magnetic resonance image (MRI) to make sure inflammation was present.
We studied 97 people – 50 on methotrexate and 47 on control medication – and followed them for six months.
As with most osteoarthritis studies, we found that pain improved in the first month in both the control and methotrexate groups. This may be because people often participate in a study when their pain is at its worst so that there is some improvement from their baseline.
However, we found that pain levels did not improve further in the control group, but continued to improve in the methotrexate group. In the methotrexate group there was improvement after three months and even more after six months. Over the full six months, the improvement in pain in the methotrexate group was twice as much as in the control group.
Read more: Opioids only slightly relieve the pain of osteoarthritis. Their deadly risks must be weighed against any benefit
There are a number of limitations to our study. Because it lasted six months, further research is needed to see if pain continues to improve as people receive treatment for longer.
We also need to see if methotrexate can reduce joint damage. This can be done by following people for one to two years and taking an X-ray to assess the condition of their joints after treatment.
Based on the results of our study, physicians may consider discussing the possibility of prescribing methotrexate to their patients who have significant symptoms of hand osteoarthritis.
The most common side effects of methotrexate are nausea and loss of appetite, which are easily treated in most patients. Less common side effects include inflammation of the liver and a decrease in white blood cell counts. But a patient taking methotrexate will have regular blood tests to catch these problems early if they occur.
A number of unanswered questions remain. We need to find out how long to use methotrexate, whether it stops joint damage and which patients are likely to benefit from methotrexate. We would especially like to see whether it helps women who suffer a lot from osteoarthritis in the hand that occurs around menopause.