Methotrexate in the treatment of erosive hand osteoarthritis

project manager

phd fellow

About the project

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 osteoarthritis is a heterogeneous disease in which joint cartilage wears down, but in recent years, inflammation has also been found to be an important disease-promoting component in some people with hand osteoarthritis. Some people with hand osteoarthritis have more inflammation in their finger joints than others, and we often see erosion of the bone surface around their joints at the same time.

Clinical and pre-clinical studies have also shown that inflammation may 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 may also have an effect on pain and disease progression in those with erosive inflammatory hand osteoarthritis.

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

Who can participate?

Adults with inflammatory erosive hand osteoarthritis without satisfactory effect on pain of paracetamol-containing analgesics or NSAIDs. Erosion is assessed by X-ray and inflammation is assessed by ultrasound by a rheumatologist.

Recruitment of participants is ongoing.

Project arrangement

Participants in the study will make 6 visits to the department and participation in the study will last for 12 months. During the study, clinical examination and ultrasound of joints will be performed, as well as standardized pain tests, blood tests, MRI of hand (twice) and X-ray of hand (three times), vital parameters and medical history. You will complete questionnaires that include pain levels, disease activity and how the disease affects your daily life.

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


All rights reserved © REMEDY; Illustration/portrait images © Nicolas Tourrenc/Diakonhjemmet Hospital