Methotrexate for osteoarthritis: a systematic review meta-analysis of randomized controlled trials.

IF 4.6 2区医学 Q2 IMMUNOLOGY

Inflammopharmacology Pub Date : 2024-11-30 DOI:10.1007/s10787-024-01604-x

Ivo Queiroz, Túlio Pimentel, Mariano Gallo Ruelas, Arthur Henrique Tavares, Lucas M Barbosa, Maria L R Defante, Giovanna N Leandro, Arthur Ribeiro Monteiro, Fernando Nunes Pimentel

{"title":"Methotrexate for osteoarthritis: a systematic review meta-analysis of randomized controlled trials.","authors":"Ivo Queiroz, Túlio Pimentel, Mariano Gallo Ruelas, Arthur Henrique Tavares, Lucas M Barbosa, Maria L R Defante, Giovanna N Leandro, Arthur Ribeiro Monteiro, Fernando Nunes Pimentel","doi":"10.1007/s10787-024-01604-x","DOIUrl":null,"url":null,"abstract":"Background: Osteoarthritis (OA) is a common joint disorder causing pain and stiffness, with limited effective treatment options. Methotrexate, known for its anti-inflammatory properties in rheumatoid arthritis, is being explored as a treatment for OA. This study evaluates Methotrexate's efficacy compared to placebo in reducing OA symptoms, such as stiffness in the knee and hand, and its impact on pain, physical function.Methods: We systematically searched PubMed, Google Scholar, Embase, Web of Science, and Cochrane databases for randomized controlled trials (RCTs), analyzing the efficacy of Methotrexate compared to placebo in patients with OA. We pooled risk ratios (RR) for binary outcomes. For continuous outcomes, we used standard mean difference (SMD) and mean difference (MD) with 95% confidence intervals (CI). Outcomes included were related to knee and hand pain, knee stiffness, and similar outcomes. We used R version 4.4.1 for statistical analyses. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach evaluated the quality of evidence.Results: This analysis included 5 RCTs comprising 465 patients, of whom 229 were randomized to Methotrexate. The age ranged from 52.4 to 67.5 years among studies. Compared with placebo, Methotrexate significantly reduced knee and hand stiffness at the end of follow-up (SMD - 0.36; 95% CI - 0.57 to - 0.15; p< 0.01), knee and hand stiffness at 6 months of follow-up (SMD - 0.48; 95% CI - 0.70 to - 0.27; p< 0.01).Conclusion: Methotrexate significantly reduced knee stiffness in both knee and hand OA. However, current literature might be underpowered, more robust RCTs are necessary to validate these findings.","PeriodicalId":13551,"journal":{"name":"Inflammopharmacology","volume":" ","pages":""},"PeriodicalIF":4.6000,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Inflammopharmacology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10787-024-01604-x","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Osteoarthritis (OA) is a common joint disorder causing pain and stiffness, with limited effective treatment options. Methotrexate, known for its anti-inflammatory properties in rheumatoid arthritis, is being explored as a treatment for OA. This study evaluates Methotrexate's efficacy compared to placebo in reducing OA symptoms, such as stiffness in the knee and hand, and its impact on pain, physical function.

Methods: We systematically searched PubMed, Google Scholar, Embase, Web of Science, and Cochrane databases for randomized controlled trials (RCTs), analyzing the efficacy of Methotrexate compared to placebo in patients with OA. We pooled risk ratios (RR) for binary outcomes. For continuous outcomes, we used standard mean difference (SMD) and mean difference (MD) with 95% confidence intervals (CI). Outcomes included were related to knee and hand pain, knee stiffness, and similar outcomes. We used R version 4.4.1 for statistical analyses. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach evaluated the quality of evidence.

Results: This analysis included 5 RCTs comprising 465 patients, of whom 229 were randomized to Methotrexate. The age ranged from 52.4 to 67.5 years among studies. Compared with placebo, Methotrexate significantly reduced knee and hand stiffness at the end of follow-up (SMD - 0.36; 95% CI - 0.57 to - 0.15; p< 0.01), knee and hand stiffness at 6 months of follow-up (SMD - 0.48; 95% CI - 0.70 to - 0.27; p< 0.01).

Conclusion: Methotrexate significantly reduced knee stiffness in both knee and hand OA. However, current literature might be underpowered, more robust RCTs are necessary to validate these findings.

查看原文本刊更多论文

甲氨蝶呤治疗骨关节炎：随机对照试验的系统回顾荟萃分析。

背景：骨关节炎（OA）是一种常见的关节疾病，引起疼痛和僵硬，有效的治疗方案有限。甲氨蝶呤因其在类风湿关节炎中的抗炎特性而闻名，目前正在探索作为OA的治疗方法。本研究评估了甲氨蝶呤与安慰剂相比在减轻OA症状（如膝关节和手部僵硬）及其对疼痛和身体功能的影响方面的疗效。方法：我们系统地检索PubMed、谷歌Scholar、Embase、Web of Science和Cochrane数据库中的随机对照试验（rct），分析甲氨蝶呤与安慰剂对OA患者的疗效。我们汇总了二元结果的风险比（RR）。对于连续结果，我们使用95%置信区间（CI）的标准平均差（SMD）和平均差（MD）。纳入的结果与膝关节和手部疼痛、膝关节僵硬和类似的结果有关。我们使用R 4.4.1版本进行统计分析。推荐、评估、发展和评价分级（GRADE）方法评估证据的质量。结果：本分析纳入5项随机对照试验，共465例患者，其中229例随机接受甲氨蝶呤治疗。研究对象的年龄从52.4岁到67.5岁不等。与安慰剂相比，甲氨蝶呤在随访结束时显著降低了膝关节和手部僵硬度(SMD - 0.36；95% CI - 0.57 ~ - 0.15；p< 0.01)，随访6个月时膝关节和手部僵硬度(SMD - 0.48；95% CI - 0.70 ~ - 0.27；p < 0.01)。结论：甲氨蝶呤可显著降低膝关节和手部OA患者的膝关节僵硬度。然而，目前的文献可能不够有力，需要更强大的随机对照试验来验证这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Inflammopharmacology IMMUNOLOGYTOXICOLOGY-TOXICOLOGY

CiteScore

8.00

自引率

3.40%

发文量

200

期刊介绍： Inflammopharmacology is the official publication of the Gastrointestinal Section of the International Union of Basic and Clinical Pharmacology (IUPHAR) and the Hungarian Experimental and Clinical Pharmacology Society (HECPS). Inflammopharmacology publishes papers on all aspects of inflammation and its pharmacological control emphasizing comparisons of (a) different inflammatory states, and (b) the actions, therapeutic efficacy and safety of drugs employed in the treatment of inflammatory conditions. The comparative aspects of the types of inflammatory conditions include gastrointestinal disease (e.g. ulcerative colitis, Crohn''s disease), parasitic diseases, toxicological manifestations of the effects of drugs and environmental agents, arthritic conditions, and inflammatory effects of injury or aging on skeletal muscle. The journal has seven main interest areas: -Drug-Disease Interactions - Conditional Pharmacology - i.e. where the condition (disease or stress state) influences the therapeutic response and side (adverse) effects from anti-inflammatory drugs. Mechanisms of drug-disease and drug disease interactions and the role of different stress states -Rheumatology - particular emphasis on methods of measurement of clinical response effects of new agents, adverse effects from anti-rheumatic drugs -Gastroenterology - with particular emphasis on animal and human models, mechanisms of mucosal inflammation and ulceration and effects of novel and established anti-ulcer, anti-inflammatory agents, or antiparasitic agents -Neuro-Inflammation and Pain - model systems, pharmacology of new analgesic agents and mechanisms of neuro-inflammation and pain -Novel drugs, natural products and nutraceuticals - and their effects on inflammatory processes, especially where there are indications of novel modes action compared with conventional drugs e.g. NSAIDs -Muscle-immune interactions during inflammation [...]