P075 Efficacy of methotrexate for symptomatic relief in patients with osteoarthritis: a systematic review and meta-analysis
Bibliographic record
Abstract
Abstract Background/Aims Osteoarthritis (OA) is a widely prevalent condition among the elderly and accounts for significant morbidity. Currently used regimens still leave patients with lifelong pain due to their lower efficacy. Emerging trials suggest a role of methotrexate (MTX) in reducing pain in OA patients. This systematic review and meta-analysis aims to assess the efficacy of methotrexate as a pain relief treatment for osteoarthritis by utilizing existing evidence from randomized placebo controlled trials. Methods A comprehensive literature search was conducted across five databases using the keywords ‘methotrexate’ and ‘osteoarthritis’ among others. A total of 676 records were screened to select randomized controlled trials (RCTs) evaluating the use of methotrexate in patients diagnosed with osteoarthritis. Data analysis was conducted using a random effects model with RevMan v5.4. Results Finally, five RCTs evaluating a total population of 474 patients were included for quantitative synthesis. All of these studies consisted of patients enrolled for treatment with MTX in one arm (238 patients), and placebo in the other arm (236 patients). Outcomes evaluated include pain, stiffness, physical function and total score as per the Western Ontario McMaster Universities Arthritis Index (WOMAC), measured at the end of 3 months and 6 months following treatment. Pain was found to be significantly higher in patients in the placebo arm, both at 3 months (mean difference [MD]:-1.72; 95% confidence interval [CI]:-2.34, -1.10; P < 0.01), and at 6 months (MD:-3.96; 95%CI:-4.77, -3.16; P < 0.01). Similarly, WOMAC-stiffness score was higher in the placebo arm at 3 months (MD:-0.51; 95%CI: -0.88, -0.14; P < 0.01) and at 6 months (MD:-0.78; 95%CI:-1.19, 0.38; P < 0.01), with both values reaching statistical significance. Physical function scores were also higher in the placebo group at 3 (MD:-0.48; 95%CI:-0.90, -0.06; P = 0.02) and 6 months (MD:-0.78; 95%CI:-1.19, -0.38; P < 0.01), indicating more functional impairment. The total WOMAC score was assessed, revealing a higher disability score in patients undertaking placebo at 3 months (MD:-7.39; 95%CI:-10.12, -4.65; P < 0.01). Conclusion Across all outcomes, better functional performance and relief of symptoms was noted in patients being administered methotrexate, indicating promising results. Further trials are needed with a larger sample size to validate these findings. Disclosure S. Rath: None. M. Sayed: None. O. Ahmad: None. Q. Mehmood: None. A.M. Ibrahim: None. A. Hasan: None.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.037 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.019 | 0.039 |
| Bibliometrics | 0.009 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".