Hand osteoarthritis—nonpharmacological and pharmacological treatments

Journal name:
Nature Reviews Rheumatology
Volume:
10,
Pages:
242–251
Year published:
DOI:
doi:10.1038/nrrheum.2013.214
Published online

Abstract

Hand osteoarthritis (OA) is a prevalent disease with a high clinical burden. The number of clinical trials in hand OA is limited and, therefore, recommendations for the management of hand OA are mostly expert-based instead of evidence-based, and medication is often prescribed off-label. However, in the past 5 years, this 'forgotten' disease has attracted increasing attention and a number of high-quality clinical trials have now been performed, or are ongoing. The results from studies conducted to assess nonpharmacological treatment modalities indicate that educating patients about self-management, the provision of assistive devices and the application of splints for thumb base OA, are effective for pain and disability. For pharmacological management, more high-quality trials are needed, although evidence is available for short-term symptom alleviation of pain by topical and oral NSAIDs. The role of anti-inflammatory medication, such as corticosteroids and biologic agents, is controversial, and the same holds true for the efficacy of symptomatic slow acting drugs for OA. Disease modifying OA drugs (DMOADs) for hand OA are currently not available. The results from the ongoing pharmacological trials will increase our knowledge for evidence-based management of hand OA in the near future.

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  1. Departments of Rheumatology and Clinical Epidemiology, Leiden University Medical Centre, P. O. Box 9600, 2300 RC Leiden, Netherlands.

    • Margreet Kloppenburg

Competing interests statement

The author received lecture/consultancy fees from Pfizer, Servier, Abbott, UCB, and BMS, and research grants from the Dutch Arthritis Foundation, Pfizer and TI Pharma.

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  • Margreet Kloppenburg

    Professor Margreet Kloppenburg gained her medical degree in 1991. After her doctoral degree in 1996, she qualified as a rheumatologist in 2000. Since 2000, she has been appointed at the departments of Rheumatology and Clinical Epidemiology at Leiden University Medical Centre. Professor Kloppenburg performs research in osteoarthritis, with special interests in hand osteoarthritis, outcome measures and aetiology.

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