MERINO
Methotrexate in the treatment of erosive hand osteoarthritis
Project Manager
Post doc
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 articular cartilage wears down, but in recent years it has also been seen that inflammation is 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 erosions in 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 can also have an effect on pain and disease progression in those with erosive inflammatory hand osteoarthritis.
The results from the MERINO study will be an important contribution to the development of treatment options for patients with hand osteoarthritis.
WHO CAN JOIN?
Adults with inflammatory erosive hand osteoarthritis without satisfactory pain relief from paracetamol-containing painkillers or NSAIDs. Erosions are assessed by X-ray and inflammation is assessed by ultrasound by a rheumatologist.
Recruitment of participants is ongoing.
WHAT DOES THE STUDY INVOLVE?
The study participants will have 6 visits to the department and participation in the study will last 12 months. During the study, a clinical examination and ultrasound of the joints will be performed, as well as standardized pain tests, blood tests, MRI of the hand (twice) and X-ray of the hand (three times), and medical history will be taken. You will complete questionnaires that include, among other things, the degree of pain, disease activity and how the disease affects your everyday life.
In a small proportion of patients with concomitant knee osteoarthritis, we wish to recruit to 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.