Efficacy and safety of non-pharmacological, pharmacological and surgical treatments for hand osteoarthritis in 2024: a systematic review
Background We aimed to update the 2018 systematic literature review on the efficacy and safety of treatments for hand osteoarthritis (OA), which was based on 126 studies.Methods We performed a systematic literature search on randomised controlled trials from June 2017 up to 31 December 2023. Risk of...
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BMJ Publishing Group
2025-01-01
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| Series: | RMD Open |
| Online Access: | https://rmdopen.bmj.com/content/11/1/e004963.full |
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| author | Féline P B Kroon Margreet Kloppenburg Ida K Haugen Ingvild Kjeken Nina Østerås Anne Therese Tveter Geir Smedslund Daniel Huseby Bordvik Kristine Aasness Fjeldstad Ingrid Skaalvik |
| author_facet | Féline P B Kroon Margreet Kloppenburg Ida K Haugen Ingvild Kjeken Nina Østerås Anne Therese Tveter Geir Smedslund Daniel Huseby Bordvik Kristine Aasness Fjeldstad Ingrid Skaalvik |
| author_sort | Féline P B Kroon |
| collection | DOAJ |
| description | Background We aimed to update the 2018 systematic literature review on the efficacy and safety of treatments for hand osteoarthritis (OA), which was based on 126 studies.Methods We performed a systematic literature search on randomised controlled trials from June 2017 up to 31 December 2023. Risk of bias was assessed using the RoB2 tool. Meta-analyses of previous and new studies regarding the efficacy for pain, function, grip strength and OMERACT/OARSI responders were performed. Certainty of evidence was judged using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) tool.Results Sixty-five new studies were included. For non-pharmacological interventions, there was low-certainty evidence for a small long-term effect of hand exercises and a moderate long-term effect of thumb orthoses for pain, and moderate-certainty evidence that assistive devices had a moderate long-term effect on function. Concerning pharmacological interventions, there was low-certainty evidence for a moderate short-term effect of oral non-steroidal anti-inflammatory drugs (NSAIDs) on pain, high- and moderate-certainty evidence for a small short-term effect of topical NSAIDs and oral glucocorticoids on function, respectively, and low-certainty evidence that oral glucocorticoids had a small short-term effect on function. Further, there was low-certainty evidence that methotrexate had a small long-term effect on pain. The heterogeneity of studies did not allow for any meta-analyses on surgery.Conclusion The results largely support current treatment recommendations. However, there is a lack of interventions that efficiently improve grip strength, and the evidence for most current treatments is still limited. To better understand action mechanism of different treatments, future trials should include hand OA subtyping and be powered for subgroup analyses. |
| format | Article |
| id | doaj-art-9f7d1de02c3a4460bafcfac302a4a066 |
| institution | Kabale University |
| issn | 2056-5933 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | RMD Open |
| spelling | doaj-art-9f7d1de02c3a4460bafcfac302a4a0662025-01-14T20:05:09ZengBMJ Publishing GroupRMD Open2056-59332025-01-0111110.1136/rmdopen-2024-004963Efficacy and safety of non-pharmacological, pharmacological and surgical treatments for hand osteoarthritis in 2024: a systematic reviewFéline P B Kroon0Margreet Kloppenburg1Ida K Haugen2Ingvild Kjeken3Nina Østerås4Anne Therese Tveter5Geir Smedslund6Daniel Huseby Bordvik7Kristine Aasness Fjeldstad8Ingrid Skaalvik9Rheumatology, Zuyderland Medical Centre, Sittard-Geleen, Limburg, NetherlandsRheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, NetherlandsCenter for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, NorwayHealth Services Research and Innovation Unit, Diakonhjemmet Hospital, Oslo, NorwayHealth Services Research and Innovation Unit, Diakonhjemmet Hospital, Oslo, NorwayHealth Services Research and Innovation Unit, Diakonhjemmet Hospital, Oslo, NorwayHealth Services Research and Innovation Unit, Diakonhjemmet Hospital, Oslo, NorwayHealth Services Research and Innovation Unit, Diakonhjemmet Hospital, Oslo, NorwayHealth Services Research and Innovation Unit, Diakonhjemmet Hospital, Oslo, NorwayHealth Services Research and Innovation Unit, Diakonhjemmet Hospital, Oslo, NorwayBackground We aimed to update the 2018 systematic literature review on the efficacy and safety of treatments for hand osteoarthritis (OA), which was based on 126 studies.Methods We performed a systematic literature search on randomised controlled trials from June 2017 up to 31 December 2023. Risk of bias was assessed using the RoB2 tool. Meta-analyses of previous and new studies regarding the efficacy for pain, function, grip strength and OMERACT/OARSI responders were performed. Certainty of evidence was judged using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) tool.Results Sixty-five new studies were included. For non-pharmacological interventions, there was low-certainty evidence for a small long-term effect of hand exercises and a moderate long-term effect of thumb orthoses for pain, and moderate-certainty evidence that assistive devices had a moderate long-term effect on function. Concerning pharmacological interventions, there was low-certainty evidence for a moderate short-term effect of oral non-steroidal anti-inflammatory drugs (NSAIDs) on pain, high- and moderate-certainty evidence for a small short-term effect of topical NSAIDs and oral glucocorticoids on function, respectively, and low-certainty evidence that oral glucocorticoids had a small short-term effect on function. Further, there was low-certainty evidence that methotrexate had a small long-term effect on pain. The heterogeneity of studies did not allow for any meta-analyses on surgery.Conclusion The results largely support current treatment recommendations. However, there is a lack of interventions that efficiently improve grip strength, and the evidence for most current treatments is still limited. To better understand action mechanism of different treatments, future trials should include hand OA subtyping and be powered for subgroup analyses.https://rmdopen.bmj.com/content/11/1/e004963.full |
| spellingShingle | Féline P B Kroon Margreet Kloppenburg Ida K Haugen Ingvild Kjeken Nina Østerås Anne Therese Tveter Geir Smedslund Daniel Huseby Bordvik Kristine Aasness Fjeldstad Ingrid Skaalvik Efficacy and safety of non-pharmacological, pharmacological and surgical treatments for hand osteoarthritis in 2024: a systematic review RMD Open |
| title | Efficacy and safety of non-pharmacological, pharmacological and surgical treatments for hand osteoarthritis in 2024: a systematic review |
| title_full | Efficacy and safety of non-pharmacological, pharmacological and surgical treatments for hand osteoarthritis in 2024: a systematic review |
| title_fullStr | Efficacy and safety of non-pharmacological, pharmacological and surgical treatments for hand osteoarthritis in 2024: a systematic review |
| title_full_unstemmed | Efficacy and safety of non-pharmacological, pharmacological and surgical treatments for hand osteoarthritis in 2024: a systematic review |
| title_short | Efficacy and safety of non-pharmacological, pharmacological and surgical treatments for hand osteoarthritis in 2024: a systematic review |
| title_sort | efficacy and safety of non pharmacological pharmacological and surgical treatments for hand osteoarthritis in 2024 a systematic review |
| url | https://rmdopen.bmj.com/content/11/1/e004963.full |
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