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RecruitingNCT07501507ADEM2Updated Sep 24, 2026

Methotrexate Treatment in Hand Osteoarthritis Refractory to Usual Treatments

A Phase 2/3 interventional study of Methotrexate Injectable Solution and Placebo in Erosive Hand Osteoarthritis, sponsored by Centre Hospitalier Universitaire de Nice. Recruiting at 1 site in France. Open to participants aged 40 Years to 85 Years. Per ClinicalTrials.gov, last updated 2026-09-24.

Sponsored by Centre Hospitalier Universitaire de Nice · Phase 2/3, Interventional, and Treatment

Phase
Phase 2/3
Study type
Interventional
Enrollment
170
Allocation
Randomized
Ages
40 Years to 85 Years
Sex
All
01

Study summary

Randomized study comparing the structural efficacy of methotrexate versus placebo in digital osteoarthritis

02

Conditions studied

  • Erosive Hand Osteoarthritis
03

Who can participate

Ages eligible
40 Years to 85 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

- Digital osteoarthritis (IPD and IPP) according to ACR criteria (with an X-ray of the hands taken less than 3 months ago, showing at least 3 joints with digital osteoarthritis KL>=2) and symptomatic for more than three months

Exclusion criteria

Exclusion Criteria:

  • Having a bilirubin level > 5 mg/dl (85.5 µmol/l)
  • Pregnant or breastfeeding women (a urine pregnancy test will be performed on women of childbearing age),
  • Injection of hyaluronic acid within the previous 6 months,
  • Injection of cortisone derivatives within the previous 3 months,
  • Presence of psoriasis,
  • Inflammatory rheumatism,
  • Microcrystalline arthropathy,
  • Joint prosthesis in one of the joints of the hand,
  • Planned placement of a joint prosthesis in the hand during the study period,
  • Major progressive disease (life-threatening cardiovascular disease, hematopoietic cancers including myeloma, cancers with risk of bone metastases),
  • Liver failure.
  • Severe renal failure (creatinine clearance less than 50 ml/min).
  • Positive hepatitis B serology.
  • Tuberculosis, hepatitis C, HIV positive, or other immunodeficiency syndromes.
  • Uncontrolled infections.
  • Use of corticosteroids.
  • Use of morphine derivatives,
  • Taking Bactrim,
  • Taking high doses of aspirin (greater than or equal to 500mg/day),
  • Contraindications to the use of methotrexate,
04

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
170 participants (estimated)

Study arms

  • Active comparator
    Methotrexate injectable

    Drug: Methotrexate Injectable Solution

  • Placebo comparator
    Placebo

    Drug: Placebo

Interventions

  • DrugMethotrexate Injectable Solution

    Injection of methotrexate every week during 12 month

  • DrugPlacebo

    The placebo consists of a 0.9% solution of sodium chloride (NaCl) in sterile distilled water for injection. This solution was chosen as the placebo. Injection every week during 12 month.

05

What researchers measure

Primary outcomes

  1. Structural lesion

    The progression of structural damage between M0 and M12, the worsening of digital osteoarthritis in a joint, will be defined by the change in stage of the Verbruggen-Veys score. The Verbruggen-Veys anatomical scoring system for hand osteoarthritis, which evaluates the radiographic progression of interphalangeal joints. This scale classifies each joint into five stages (N, S, J, E, R) reflecting increasing severity of structural damage. Progression is defined as a transition to a more advanced stage between M0 and M12. As this is a categorical ordinal scale rather than a continuous numerical score, there are no minimum or maximum numerical values. However, higher stages correspond to more severe structural damage and thus a worse outcome.

    Time frame: 12 months

Secondary outcomes

  1. Function

    Hand function will be assessed using the Australian/Canadian Osteoarthritis Hand Index (AUSCAN). The AUSCAN is a validated patient-reported outcome measure that evaluates pain, stiffness, and physical function in hand osteoarthritis. The function subscale consists of 9 items, each scored on a Likert scale. The total function score ranges from 0 to 36, with higher scores indicating worse functional impairment. Changes in the AUSCAN function score between baseline (M0) and 12 months (M12) will be analyzed.

    Time frame: 12 months

  2. Effectiveness of the treatment on pain

    The effectiveness of the treatment on pain will be assessed using a Visual Analog Scale (VAS) for pain, a validated patient-reported outcome measure. The VAS consists of a 100 mm horizontal line, where 0 mm indicates "no pain" and 100 mm indicates "worst imaginable pain". The outcome will be expressed as the mean pain score (in millimeters) and the change in pain score from baseline (M0) at each time point (M3, M9, and M12). Higher scores indicate greater pain intensity and therefore a worse outcome.

    Time frame: 12 months

06

Study locations

1 of 1 sites recruiting
  • CHU de Nice
    Nice, 06000, France
    Recruiting
07

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07501507
Lead sponsor
Centre Hospitalier Universitaire de Nice
Responsible party
Sponsor
First posted
Mar 30, 2026
Start date
Sep 23, 2026
Primary completion
Feb 2028 (estimated)
Completion
Feb 2028 (estimated)
Last update
Sep 24, 2026

Study contacts

Christian ROUX, Pr
Contact
roux.c@chu-nice.fr
492035512 ext. +33
Yacine ALLAM, Dr
principal investigator · Centre Hospitalier Universitaire de Nice

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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