Skip to main content


Methotrexate in the treatment of erosive hand osteoarthritis

Project Manager
Post doc


During their lifetime, almost half of all women and a quarter of men will develop hand osteoarthritis in one or more joints. There is currently no specific cure or disease-modifying treatment for hand osteoarthritis. Hand arthrosis is a heterogeneous disease in which articular cartilage wears down, but in recent years it has also been seen that inflammation is an important disease-promoting component in some with hand arthrosis. Some people with hand osteoarthritis have more inflammation in their finger joints than others, and often at the same time we see erosions in the bone surface around their joints.

Clinical and pre-clinical studies have also shown that inflammation can be a possible treatment target for pain and progression. Methotrexate is an approved anti-rheumatic drug for the treatment of, for example, arthritis. The study will investigate whether methotrexate can also have an effect on pain and disease progression in those with erosive inflammatory hand arthrosis.

The results from the MERINO study will be an important contribution to the development of treatment alternatives for patients with hand osteoarthritis.


Adults with inflammatory erosive hand arthrosis without a satisfactory effect on pain from paracetamol-containing painkillers or NSAIDs. Erosions are assessed on X-ray and inflammation is assessed with ultrasound by a rheumatologist.

Recruitment of participants is ongoing.


The participants in the study will make 6 visits to the department and participation in the study will last for 12 months. During the course of the study, clinical examination and ultrasound of joints will be carried out, as well as standardized pain tests, blood samples will be taken, MRI of the hand (twice) and X-ray of the hand (three times), vital parameters and medical history. You will fill in questionnaires that include, among other things, degree of pain, disease activity and how the disease affects your everyday life.

In a small proportion of patients with simultaneous knee osteoarthritis, we want to recruit for a sub-study where we take a needle biopsy from the knee before starting methotrexate and after six months of treatment. Such a study will provide ground-breaking information about the genes that are actively involved in regulating inflammation in osteoarthritis and how these are affected by treatment.