Patients with hand osteoarthritis experienced improvements in pain and function with low-dose prednisolone treatment, according to a study presented at the European Congress of Rheumatology in Madrid, Spain (12 June 2019)
Researchers in the Netherlands randomised 92 patients with painful hand osteoarthritis and signs of synovial inflammation to receive prednisolone 10mg daily or placebo. After six weeks, treatment was tapered over a further two weeks, followed by another six weeks without study medication.
Finger pain was assessed using a visual analogue scale, with an average -16.5 point difference in favour of prednisolone over placebo at week six (95% confidence interval; -26.1 to -6.9). Patients treated with prednisolone also showed significant improvements in function and were more likely to be classed as responders using OMERACT-OARSI criteria (72% vs. 33%), a measure of treatment response in terms of pain, function, and patient’s global assessment.
The researchers reported that adverse events were mostly mild and comparable between groups.
Treatment for hand osteoarthritis is generally limited to non-steroidal anti-inflammatory drugs. However, studies suggest that synovial inflammation is often present in hand osteoarthritis and is a main determinant of pain and radiographic disease progression.
“Our study provides evidence that local inflammation is a suitable target for drug treatment in hand osteoarthritis,” said FÃ©line Kroon, lead researcher on the study.
 Kroon F, Kortekaas M, Boonen A et al. Low-dose prednisolone in patients with hand osteoarthritis (HOPE): results from a randomised double-blind placebo-controlled trial. [Presentation] European Congress of Rheumatology; Madrid. 12 June 2019. Available at: https://www.eular.org/sysModules/obxContent/files/www.eular.2015/1_42291DEB-50E5-49AE-5726D0FAAA83A7D4/01_abstract_op0180_prednisolone_in_hand_oa_final.pdf (acccessed June 2019)