Hand osteoarthritis: oral therapy or injections?
Hand osteoarthritis is often stressful for those affected and accompanied functional restrictions. Effective treatment options are essential.
Forms of therapy for hand osteoarthritis treatment
- Oral NSAIDs and glucocorticoids showed good efficacy in the analysis.
- Glucocorticoids were superior to NSAIDs.
- Injections and local NSAIDs were no more effective than placebo.
Hand osteoarthritis: a painful condition
People with hand osteoarthritis often suffer from pain and possibly limited hand function. The disease is on the rise in many countries. A recent meta-analysis has therefore looked at which interventions can quickly provide relief from this painful condition and reduce pain. Data from over 70 studies and over 7,5000 people were analysed and evaluated.
Which therapy performs best?
The study produced clear results:
- Oral therapies with NSAIDs or glucocorticoids are effective in the treatment of osteoarthritis of the hands.
- Oral steroids are more effective than painkillers.
- The data suggest that injections were not more effective than placebo.
- Topical pain medications such as NSAID-containing ointments were also not superior to placebo.
Which injections were studied?
The study compared the efficacy of various drugs with placebo:
- Intra-articular steroids.
- Intra-articular hyaluronan.
- Intra-articular hydroxychloroquine.
After analysing the data, all injections showed no superiority over placebo.
Implications for therapy
The analysis data suggest that oral therapeutics are the most effective in the treatment of hand osteoarthritis. Both oral glucocorticoids and oral NSAIDs showed good efficacy. Both were more effective than placebo, and steroids were more effective than NSAIDs. Injections and topical therapies such as NSAID-containing ointments were inferior to placebo in the studies analysed.
Oral glucocorticoids appear to be an effective option for the treatment of hand osteoarthritis. The same applies to oral NSAIDs. Injections and local NSAID applications, on the other hand, appear to be less effective.
- Døssing A, Nielsen SM, Kroon FP, Balsby IM, Tarp S, Kloppenburg M, Stamp L, Haugen IK, Altman RD, Henriksen M, Boesen M, Bliddal H, Berg S, Christensen R. Comparative effectiveness of pharmacological interventions for hand osteoarthritis: a systematic review and network meta-analysis of randomised trials. RMD Open. 2023 Aug;9(3):e003030. doi: 10.1136/rmdopen-2023-003030. PMID: 37734873; PMCID: PMC10537980.