Intra-articular methotrexate. Clinical and laboratory study in rheumatoid and psoriatic arthritis.

Abstract

The effects of intra-articular methotrexate (MTX) were compared with saline in 20 patients with persistent knee effusions due to rheumatoid arthritis (15) psoriasis (5) in a double-blind pilot study. Clinical improvement was seen in most patients given either MTX or saline and was attributed to joint irrigation during arthroscopy and to placebo effects. MTX had a local anti-inflammatory effect in the psoriatic arthropathies; the percentage of polymorphonuclear cells and pyoninophilic mononuclear cells in synovial fluids fell sharply. Intra-articular hydrocortisone acetate was not anti-inflammatory in 2 psoriatic patients treated subsequently. The anti-inflammatory action of MTX in joints may resemble its effectiveness in controlling the rash of psoriasis.