Methotrexate for Pain and Function in Osteoarthritis .
Efficacy and safety of methotrexate in osteoarthritis: A systematic review and meta-analysis of randomized controlled trials.
Osteoarthritis Cartilage . 2025 Jun;33(6):680-691.Six randomized controlled trials including 602 patients with knee or hand osteoarthritis were included in this systematic review and meta-analysis comparing methotrexate with placebo (five trials) or glucosamine (one trial). Pooled outcomes of interest included pain, physical function, quality of life, adverse events, and osteoarthritis-related biochemical and imaging biomarkers. Methotrexate significantly reduced pain and improved knee function, but did not improve hand function or quality of life, and did not increase adverse events. The findings suggest methotrexate can provide clinically relevant pain relief and functional improvement in knee OA without additional safety risks.
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