Oral NSAIDs, Glucocorticoids Seem Effective for Hand Osteoarthritis

FRIDAY, Sept. 29, 2023 (HealthDay News) -- Oral nonsteroidal anti-inflammatory drugs (NASIDs) and glucocorticoids seem to be effective for hand osteoarthritis (OA), according to a review published online Sept. 28 in RMD Open.

Anna Døssing, M.D., from the University of Copenhagen in Denmark, and colleagues conducted a systematic review of randomized trials to explore the effectiveness of pharmacological interventions for hand OA. Seventy-two trials with 7,609 participants were included; 65 trials with 5,957 participants were eligible for the quantitative synthesis, examining 29 pharmacological interventions.

The researchers found that the oral NSAID and oral glucocorticoid network meta-analysis (NMA) effect sizes (95 percent credible intervals) were −0.18 (−0.36 to 0.02) and −0.54 (−0.83 to −0.24), respectively, compared with placebo; when limiting evidence to the pairwise meta-analysis of trials without a high risk for bias, the result was consistent. Compared with placebo, intra-articular hyaluronate, intra-articular glucocorticoid, hydroxychloroquine, and topical NSAID NMA effect sizes (95 percent credible intervals) were 0.22 (−0.08 to 0.51), 0.25 (0.00 to 0.51), −0.01 (−0.19 to 0.18), and −0.14 (−0.33 to 0.08), respectively. Inferiority was seen for oral NSAIDs versus oral glucocorticoids, with an NMA effect size of 0.36 (95 percent credible interval, 0.01 to 0.72). When stratifying for thumb and finger OA, no intervention was superior to placebo.

"Many pharmacological treatments for hand OA pain are available, of which most have no proven efficacy," the authors write. "For hand OA, oral NSAIDs and oral glucocorticoids appear effective, whereas the efficacy of topical NSAIDs remains questionable."

Several authors disclosed ties to the pharmaceutical, medical technology, and publishing industries.

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