Low-dose methotrexate compared to placebo in the treatment of knee osteoarthritis
Low-dose methotrexate compared to placebo in the treatment of knee osteoarthritis
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DOI：
10.1590/s0482-50042007000500008
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发表时间：
2007-10-01
影响因子：
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通讯作者：
Pucinelli, Mário Luis Cardoso
中科院分区：
文献类型：
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作者：
Holanda, Haroldo Tenório de;Pollak, Daniel Feldman;Pucinelli, Mário Luis Cardoso
目的：评价小剂量甲氨蝶呤治疗膝骨关节炎的疗效。方法：在一项为期 4 个月的前瞻性、双盲、安慰剂对照、随机研究中，58 名患者被分为两组。第 1 组接受每周 7.5 毫克剂量的甲氨蝶呤，第 2 组接受安慰剂。西安大略大学和麦克马斯特大学骨关节炎指数（WOMAC）、Lequèsne 算法功能指数和疼痛视觉模拟量表（VAS）被用作初步评估的衡量标准。用于镇痛的扑热息痛的量作为辅助评估。结果：第 2 组患者的平均年龄为 60.4 岁，第 1 组患者的平均年龄为 61.8 岁 (p = 0.43)。在这两个组中，女性均占主导地位，其中第 1 组中女性占 93.1%，第 2 组中女性占 72.4% (p = 0.08)。两组之间在 WOMAC (p = 0.94)、Lequèsne (p = 0.87) 和 VAS (p = 0.89) 方面没有统计学显着差异。同样，两组之间的扑热息痛消耗量也没有统计学显着差异。然而，安慰剂组有增加消耗的趋势。结论：与安慰剂相比，甲氨蝶呤治疗膝骨关节炎既不能缓解症状，也不能减少功能限制。甲氨蝶呤显示出减少膝骨关节炎中扑热息痛消耗量的趋势。
OBJECTIVE: to evaluate the efficacy of low-dose methotrexate in the treatment of knee osteoarthritis. METHODS: 58 patients were separated into two groups in a prospective, double-blinded, placebo-controlled, randomized 4 months study. Group 1 received a 7,5 mg weekly dose of methotrexate whilst group 2 received placebo. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequèsne Algofunctional Index and the Visual Analogue Scale (VAS) for pain were utilized as measurement of primary evaluation. The quantity of paracetamol used for analgesia served as a secondary evaluation. RESULTS: the patient’s average age was of 60.4 years in the group 2 and 61.8 years in group 1 (p = 0.43). In both groups, women predominated, comprising 93.1% in group 1 and 72.4% in group 2 (p = 0.08). There were no statistically significant difference between both groups regarding WOMAC (p = 0.94), Lequèsne (p = 0.87) and VAS (p = 0.89. Likewise, in the paracetamol consumption there was not statistically significant difference between both groups. However, there was tendency to increased consumption in the placebo group. CONCLUSION: methotrexate provided neither symptomatic relief nor did it reduce the functional limitation when compared to placebo in knee osteoarthritis. Methotrexate showed a tendency to decrease the consumption of paracetamol in knee osteoarthritis.