Methotrexate, a drug used for decades to treat certain cancers as well as psoriasis and rheumatoid arthritis, may also help relieve Pain caused by hand osteoarthritis, a new study suggests.

Researchers randomly assigned 97 adults with hand osteoarthritis (OA) and inflammation to take a 20-milligram methotrexate pill or a placebo once weekly for six months. While pain improved initially for both groups, it eased significantly more by the end of the study for people taking methotrexate, according to results published in The Lancet.

Overall, pain improved twice as much with methotrexate as it did without the drug, the study found.

“We know that inflammation in hand OA causes pain and joint damage,” says senior study author Flavia Cicuttini, PhD, a professor and head of the musculoskeletal unit at Monash University and the rheumatology department at Alfred Hospital, both in Melbourne, Australia.

“Our results suggest that targeting this inflammation is important and works, and that it can be done with a medication such as methotrexate,” Dr. Cicuttini adds.

Methotrexate is effective at treating the symptoms of certain inflammatory conditions like rheumatoid arthritis because it slows down activity in the immune system and reduces swelling and inflammation. Newer injected medicines known as tumor necrosis factor (TNF) inhibitors — which can treat a wide range of other inflammatory conditions — don’t improve hand OA, and there currently aren’t any highly effective treatments for hand OA, Cicuttini says.

In the new study, both people on the placebo and on methotrexate experienced less pain after about one month, Cicuttini says. But after that, pain levels stayed the same in the placebo group and continued to improve for participants taking methotrexate, decreasing more at three months and at six months of treatment.

Based on these findings, it may make sense for doctors to offer methotrexate to patients for three to six months to see if it helps, Cicuttini says.

However, this drug is rarely used for hand OA right now, and doctors will likely want more data from larger, longer studies before methotrexate becomes a regular part of treatment regimens, says Nilanjana Bose, MD, of Lonestar Rheumatology in Houston.

“Right now, unfortunately, we don’t have good treatments for hand OA,” says Dr. Bose, who wasn’t involved in the new study. “We can offer options like squeeze balls or paraffin wax for heat therapy, but at the end of the day they don’t always make a big difference. We need more studies on methotrexate, but if it does work, patients would really benefit from having an effective drug.”