In his recent Photoclinic case of a woman with synovial cysts associated with osteoarthritis (OA), Dr Dmitry Shtrambrand mentioned that methotrexate was part of the treatment regimen (CONSULTANT, May 2006, page 688). I am unfamiliar with this therapy. Are there published studies that support the use of methotrexate in patients with OA?
— John Mosby, MD
My patient was treated by a rheumatology consultant. Although I am not aware of any research supporting methotrexate therapy for OA, there is some evidence that hydroxychloroquine—another disease-modifying antirheumatic drug (DMARD)—is effective for erosive OA (also known as inflammatory OA).1 This patient has erosive OA (not common OA) in multiple joints, so it would be reasonable to at least try a DMARD to stabilize the disease.
— Dmitry Shtrambrand, MD
1. Bryant LR, des Rosier KF, Carpenter MT. Hydroxychloroquine in the treatment of erosive osteoarthritis. J Rheumatol. 1995;22:1527-1531.