An Antirheumatic Agent for Osteoarthritis?

Is methotrexate an appropriate therapy for synovial cysts associated with osteoarthritis?

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
    Hampton, Ga

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
    Passaic, NJ




Bryant LR, des Rosier KF, Carpenter MT. Hydroxychloroquine in the treatment of erosive osteoarthritis.

J Rheumatol

. 1995;22:1527-1531.