Takeaway
- The HOPE trial, a 6-week randomised controlled trial (RCT) of patients with a flare-up of hand osteoarthritis, has found that 10 mg prednisolone daily effectively reduces pain.
Why this matters
- Hand osteoarthritis has a high burden of disease (8%-10% of the population) and unmet medical need.
- High-dose prednisolone represents a new short-term treatment option for patients with flare-ups.
Study design
- Double-blind, randomised, placebo-controlled RCT (n=92) in the Netherlands.
- Patients were eligible with symptomatic hand osteoarthritis (finger pain of ≥30 mm on a 100-mm visual analogue scale [VAS]) and signs of inflammation in their distal and proximal interphalangeal joints by imaging.
- Patients were randomly assigned to placebo or 10-mg oral prednisolone once daily for 6 weeks, followed by a 2-week tapering scheme.
- Funding: Dutch Arthritis Society.
Key results
- The prednisolone group had greater finger pain reduction at week 6 compared with baseline in mean VAS scores (−21.5±21.7 mm standard deviation vs −5.2±24.3 mm in the placebo group; between-group difference of −16.5 mm; P=.0007).
- Nonserious adverse events were similar across groups.
- There were 5 serious events: 1 in the prednisolone group (a myocardial infarction) and 4 in the placebo group.
Limitations
- Patients may not be representative of all patients with painful hand osteoarthritis.
References
References
