Xing Wang1, Peng Wang2, Andrew Faramand3, Xi Zha2, Yu Zhang1,2, Weelic Chong4, Yang Hai5, Fang Fang6. 1. Department of Neurosurgery, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China. 2. Clinical Medical College, Chengdu University, Chengdu, Sichuan, China. 3. Medical Center, University of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA. 4. Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, USA. 5. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA. 6. Department of Neurosurgery, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, China. fang1057@outlook.com.
Abstract
OBJECTIVE: To assess the efficacy and safety of corticosteroid therapy including oral corticosteroid and intra-articular corticosteroid in patients with hand osteoarthritis (OA), to provide treatment recommendations, and provide data-driven suggestions for future studies. METHODS: A systematic review of the literature was performed from inception to February 19, 2020, and the study was conducted on February 20, 2020. All controlled trials in Ovid MEDLINE, EMBASE, and Cochrane library reporting the efficacy on pain, functional recovery, and adverse events of corticosteroids in hand osteoarthritis were selected. The primary outcome was pain assessed on a visual analogue scale (VAS) lasting for up to 24 weeks. Pooled mean difference (MD) for continuous variable and risk ratio (RR) for dichotomous variable, with 95% confidence intervals (CIs), was assessed by a random effects model. RESULTS: Overall, seven trials totaling 511 participants were included in this study. The pooled analysis showed a significant difference in VAS pain (MD, - 5.75; 95% CI, - 10.08 to - 1.42, I2 = 40%). No significant differences were observed in any of the adverse events. CONCLUSION: Our data suggest corticosteroids in hand OA might improve local pain and promote functional recovery. However, since these findings were based on only 7 studies and due to significant heterogeneity across the included studies, these findings need to be confirmed by future clinical trials with a higher number of patients. KEY POINTS: • Current evidences of glucocorticoids for the management of hand osteoarthritis (OA) were insufficient and more evidences were needed. • The results of the present meta-analysis revealed corticosteroids in hand OA might improve local pain and promote functional recovery. • These findings need to be confirmed by future clinical trials with a higher number of patients.
OBJECTIVE: To assess the efficacy and safety of corticosteroid therapy including oral corticosteroid and intra-articular corticosteroid in patients with hand osteoarthritis (OA), to provide treatment recommendations, and provide data-driven suggestions for future studies. METHODS: A systematic review of the literature was performed from inception to February 19, 2020, and the study was conducted on February 20, 2020. All controlled trials in Ovid MEDLINE, EMBASE, and Cochrane library reporting the efficacy on pain, functional recovery, and adverse events of corticosteroids in hand osteoarthritis were selected. The primary outcome was pain assessed on a visual analogue scale (VAS) lasting for up to 24 weeks. Pooled mean difference (MD) for continuous variable and risk ratio (RR) for dichotomous variable, with 95% confidence intervals (CIs), was assessed by a random effects model. RESULTS: Overall, seven trials totaling 511 participants were included in this study. The pooled analysis showed a significant difference in VAS pain (MD, - 5.75; 95% CI, - 10.08 to - 1.42, I2 = 40%). No significant differences were observed in any of the adverse events. CONCLUSION: Our data suggest corticosteroids in hand OA might improve local pain and promote functional recovery. However, since these findings were based on only 7 studies and due to significant heterogeneity across the included studies, these findings need to be confirmed by future clinical trials with a higher number of patients. KEY POINTS: • Current evidences of glucocorticoids for the management of hand osteoarthritis (OA) were insufficient and more evidences were needed. • The results of the present meta-analysis revealed corticosteroids in hand OA might improve local pain and promote functional recovery. • These findings need to be confirmed by future clinical trials with a higher number of patients.
Authors: R Altman; G Alarcón; D Appelrouth; D Bloch; D Borenstein; K Brandt; C Brown; T D Cooke; W Daniel; R Gray Journal: Arthritis Rheum Date: 1990-11
Authors: Margreet Kloppenburg; Féline Pb Kroon; Francisco J Blanco; Michael Doherty; Krysia S Dziedzic; Elsie Greibrokk; Ida K Haugen; Gabriel Herrero-Beaumont; Helgi Jonsson; Ingvild Kjeken; Emmanuel Maheu; Roberta Ramonda; Marco Jpf Ritt; Wilma Smeets; Josef S Smolen; Tanja A Stamm; Zoltan Szekanecz; Ruth Wittoek; Loreto Carmona Journal: Ann Rheum Dis Date: 2018-08-28 Impact factor: 19.103
Authors: Yuqing Zhang; Jingbo Niu; Margaret Kelly-Hayes; Christine E Chaisson; Piran Aliabadi; David T Felson Journal: Am J Epidemiol Date: 2002-12-01 Impact factor: 4.897
Authors: Sharon L Kolasinski; Tuhina Neogi; Marc C Hochberg; Carol Oatis; Gordon Guyatt; Joel Block; Leigh Callahan; Cindy Copenhaver; Carole Dodge; David Felson; Kathleen Gellar; William F Harvey; Gillian Hawker; Edward Herzig; C Kent Kwoh; Amanda E Nelson; Jonathan Samuels; Carla Scanzello; Daniel White; Barton Wise; Roy D Altman; Dana DiRenzo; Joann Fontanarosa; Gina Giradi; Mariko Ishimori; Devyani Misra; Amit Aakash Shah; Anna K Shmagel; Louise M Thoma; Marat Turgunbaev; Amy S Turner; James Reston Journal: Arthritis Rheumatol Date: 2020-01-06 Impact factor: 10.995
Authors: Jaime C Branco; Ana M Rodrigues; Nélia Gouveia; Mónica Eusébio; Sofia Ramiro; Pedro M Machado; Leonor Pereira da Costa; Ana Filipa Mourão; Inês Silva; Pedro Laires; Alexandre Sepriano; Filipe Araújo; Sónia Gonçalves; Pedro S Coelho; Viviana Tavares; Jorge Cerol; Jorge M Mendes; Loreto Carmona; Helena Canhão Journal: RMD Open Date: 2016-01-19