RoB | Study | Design | Intervention | Frequency, duration | N | OA location, definition | Women (%) | Age (years) | Primary outcome |
Topical NSAIDs | |||||||||
Altman et al 200952 | RCT | Topical diclofenac gel 1% | 4 per day, 8 weeks | 198 | ACR, Rx KL1–3 | 77 | 63.6 (10.3) | VAS pain, AUSCAN, VAS patient global | |
Topical placebo cream | 187 | 77 | 64.7 (9.6) | ||||||
Graber et al 199739 | RCT | Topical ibuprofen cream | 3 per day, 2 weeks | 57 | ACR or clinical diagnosis isolated CMC OA | 91 | 65.8 (8.6) | FIHOA | |
Berthollet treatment (local steam bath and finger shower) | Daily, 3 weeks | 59 | 86 | 63.2 (10.0) | |||||
Michalsen et al 200892 | RCT | Diclofenac gel 10 mg/g | 2 per day, 4 weeks | 16 | CMC, clinical diagnosis and Rx damage | 100 | 64.3 (9.1) | VAS pain | |
Medicinal leeches | Once in 4 weeks | 16 | 64.1 (6.4) | ||||||
Romero et al 201355 | RCT | Topical diclofenac gel 2% | 3 per day, 4 weeks | 65 | ACR | 86 | 62 (10.2) | NR | |
Topical herbal cream | 65 | 95 | |||||||
Talke et al 198550 | RCT | Topical etofenamate 100 mg/g | 3 per day, 3 weeks | 30 | IP, clinical diagnosis, 'activated' | 83 | 64.3 (13.5) | NR | |
Oral indomethacin 150 mg/day | 3 weeks | 30 | 90 | 63.3 (11.0) | |||||
Widrig et al 200754 | RCT | Topical ibuprofen cream 5% | 3 per day, 3 weeks | 99 | ACR | 61 | 64 (11.4) | VAS pain, FIHOA | |
Topical arnica cream 50% | 105 | 67 | 64 (12.0) | ||||||
Zacher et al 200151 | RCT | Topical diclofenac gel 1% | 4 per day, 3 weeks | 165 | IP, clinical diagnosis, 'activated' | 86 | 60.7 (9.4) | VAS pain improve≥40% | |
Oral ibuprofen 1200 mg/day | 3 weeks | 156 | 90 | 63.2 (9.4) | |||||
Oral NSAIDs | |||||||||
Dreiser et al 199362 | RCT | Ibuprofen 800 mg/day | 2 weeks | 30 | Rx damage, pain exacerbation | 80 | 58.5 (1.7) | NR | |
Placebo | 30 | 90 | 60.3 (2.0) | ||||||
Grifka et al 200463 | RCT | Lumiracoxib 200 mg/day | 4 weeks | 205 | ACR | 82 | 62.0 (12.1) | VAS pain | |
Lumiracoxib 400 mg/day | 193 | 83 | 61.0 (12.4) | ||||||
Placebo | 196 | 83 | 62.7 (11.7) | ||||||
Muratore et al 200465
(A) | RCT | Ketoprofen lysine salt 160 mg/day+glucosamine+chondroitin sulfate | 20 days | 30 | Hand, NR | 100 | NR | NR | |
Glucosamine+chondroitin sulfate | 28 | ||||||||
Rovetta et al,2001-B49 | CCT | Dexketoprofen-trometamol 50 mg/day | 3 weeks | 35 | ACR, 'active OA' | 86 | 57.7 (3.4) | Morning stiffness (WOMAC) | |
No intervention | 19 | 63 | |||||||
Rovetta et al, 2001-A48 | CO (WA-) | Dexketoprofen-trometamol 50 mg/day | 13 days | 36 | ACR, 'active OA' | NR | NR | Morning stiffness and pain (WOMAC) | |
Paracetamol 1000 mg/day | |||||||||
Seiler 198364 | RCT | Meclofenamate sodium 300 mg/day | 4 weeks | 22 | Clinical diagnosis,≥1 inflamed DIP and Rx damage | 95 | 62.5 (34–77) | NR | |
Placebo | 19 | 84 | 65.0 (49–80) | ||||||
Talke 198550 | RCT | Oral indomethacin 150 mg/day | 3 weeks | 30 | IP, clinical diagnosis, 'activated' | 83 | 64.3 (13.5) | NR | |
Topical etofenamate 100 mg/g | 3 per day, 3 weeks | 30 | 90 | 63.3 (11.0) | |||||
Zacher et al 200151 | RCT | Oral ibuprofen 1200 mg/day | 3 weeks | 156 | IP, clinical diagnosis,'activated' | 90 | 63.2 (9.4) | VAS pain improve≥40% | |
Topical diclofenac gel 1% | 4 per day, 3 weeks | 165 | 86 | 60.7 (9.4) | |||||
Chondroitin sulfate | |||||||||
Gabay et al 201166 | RCT | Chondroitin sulfate 800 mg/day | 6 months | 80 | ACR | 73 | 63.9 (8.5) | VAS pain, FIHOA | |
Placebo | 82 | 76 | 63.0 (7.2) | ||||||
Verbruggen 200244 | RCT | Chondroitin polysulphate 50 mg/day intramuscularly | 3 years | 66 | IP, clinical diagnosis and Rx damage | 91 | 55.2 (6.7) | Rx progression | |
Placebo intramuscularly | 64 | 97 | 56.1 (9.2) | ||||||
RCT | Chondroitin sulfate 1200 mg/day | 3 years | 44 | IP, clinical diagnosis and Rx damage | 91 | 57.6 (7.1) | Rx progression | ||
Placebo | 48 | 88 | 55.9 (8.9) | ||||||
Intra-articular glucocorticoids | |||||||||
Bahadiret al 200973 | RCT | Glucocorticoid i.a. 20 mg/0.5 mL | Once | 20 | CMC, Rx E-L stage II–III | 100 | 62.9 (9.1) | NR | |
Hyaluronic acid i.a. 5 mg/0.5 mL | 1 per week, 3 weeks | 20 | 60.8 (7.3) | ||||||
Fuchs et al 200674 | RCT | Glucocorticoid i.a. 10 mg/1 mL | 1 per week, 3 weeks | 28 | CMC, clinical diagnosis and Rx KL>0 | 80 | Median 61.0 | NR | |
Hyaluronic acid i.a. 10 mg/1 mL | 28 | Median 59.5 | |||||||
Heyworth et al 200868 | RCT | Glucocorticoids i.a.1 mL | Once+1 i.a. placebo, 2 weeks | 22 | CMC, Rx E-L stage I–IV | 90 | 60 (9.4) | NR | |
Hyaluronic acid i.a. 8 mg/1 mL | 1 per week, 2 weeks | 28 | 80 | 65 (10.6) | |||||
Placebo i.a. (1 mL, saline) | 1 per week, 2 weeks | 18 | 89 | 64 (8.5) | |||||
Jahangiri 201493 | RCT | Gluocorticoid i.a. 40 mg/0.5 mL+0.5 mL lidocaine | Once+2 i.a. placebo, 3 weeks | 30 | CMC, clinical diagnosis and Rx E-L stage>I | 70 | 63.3 (10.1) | VAS pain | |
Dextrose i.a. 100 mg/0.5 mL+0.5 mL lidocaine | 1 per week, 3 weeks | 30 | 77 | 63.9 (9.4) | |||||
Mandl,et al
201269(A) | RCT | Glucocorticoid i.a. 40 mg/1 mL | Once+1 i.a. placebo,2 weeks | 65 | CMC, clinical diagnosis and Rx KL>0 | 68 | 66.5 (45–89) | NR | |
Hyaluronic acid i.a. 8 mg/1 mL | 1 per week, 2 weeks | 62 | |||||||
Placebo i.a. (1 mL, bupivacaine) | 1 per week, 2 weeks | 61 | |||||||
Meenagh et al 200470 | RCT | Glucocorticoid i.a. 5 mg/0.25 mL | Once | 20 | CMC, NR | 95 | 60.6 (41–71) | VAS pain improve≥20% | |
Placebo i.a. (0.25 mL, saline) | 20 | 85 | 59.3 (46–69) | ||||||
Monfort et al 201475 | RCT | Glucocorticoid i.a. 3 mg/0.5 mL | 1 per week, 3 weeks | 40 | CMC, clinical diagnosis and Rx KL1–3 | 88 | 62.8 (8.7) | FIHOA | |
Hyaluronic acid i.a. 5 mg/0.5 mL | 48 | ||||||||
Spolidoro,et al
201571 | RCT | Glucocorticoid i.a.4 mg/0.2 mL (DIP) or 6 mg/0.3 mL(PIP)+0.1 mL lidocaine | Once | 30 | IP, clinical diagnosis and Rx osteophyte | 100 | 60.7 (9.1) | VAS pain, VAS joint swelling | |
Placebo i.a. (0.1 mL, lidocaine) | 30 | 93 | 60.7 (7.3) | ||||||
Stahl et al 200576 | RCT | Glucocorticoid i.a. 40 mg/1 mL | Once | 25 | CMC, Rx E-L stage II | 84 | 62 (50–91) | NR | |
Hyaluronic acid i.a. 15 mg/1 mL | 27 | 92.5 | 62 (37–80) | ||||||
Oral glucocorticoids | |||||||||
Kvien et al 200881 | RCT | Prednisone 3 mg/day+dipyridamole 200 mg/day | 6 weeks | 42 | ACR, Rx KL>1 | 93 | 61.1 (5.0) | AUSCAN pain | |
Placebo | 41 | 93 | 59.6 (5.3) | ||||||
Wenham et al 201282 | RCT | Prednisone 5 mg/day | 4 weeks | 35 | ACR, Rx KL>0 | 74 | 61.9 (6.6) | VAS pain | |
Placebo | 35 | 89 | 61.1 (9.0) | ||||||
Hydroxychloroquine | |||||||||
Basoski et al 201583(A) | RCT | Hydroxychloroquine 400 mg/day | 24 weeks | 98 | ACR | 86 | 57 | VAS pain | |
Placebo | 98 | ||||||||
Kingsbury,et al 201684(A) | RCT | Hydroxychloroquine 200–400 mg/day | 1 year | 124 | ACR | NR | NR | NRS pain | |
Placebo | 124 | ||||||||
McKendry et al 200159(A) | RCT | Hydroxychloroquine 400 mg/day | 24 weeks | 29 | Hand, NR | NR | NR | NR | |
Paracetamol 3900 mg/day | 29 | ||||||||
Placebo | 30 | ||||||||
TNF inhibitors | |||||||||
Aitken et al 201746(A) | CO (WA+) | Adalimumab 40 mg subcutaneously | 2 subcutaneously per 2 weeks,12 weeks | 43 | ACR, erosive (Rx erosion), MRI synovitis | 77 | 61 (8.4) | AUSCAN pain | |
Placebo subcutaneously | |||||||||
Chevalier et al 201585 | RCT | Adalimumab 40 mg subcutaneously | Once 2 subcutaneously,2 weeks | 42 | ACR, Rx damage IPs | 87 | 62.8 (6.9) | VAS pain improve≥50% | |
Placebo subcutaneously | 43 | 83 | 62.2 (7.0) | ||||||
Kloppenburg et al 201647 86 87
(A) | RCT | Etanercept 25–50 mg subcutaneously | 1 subcutaneously per week, 1 year | 45 | IP, ACR, erosive (Rx erosion IP) | 82 | 59.4 (6.5) | VAS pain | |
Placebo subcutaneously | 45 | 80 | 60.1 (8.7) | ||||||
Verbruggen et al 201245 | RCT | Adalimumab 40 mg subcutaneously | 1 subcutaneously per 2 weeks, 1 year | 30 | IP, ACR, erosive (Rx erosion IP) | 87 | 61.9 (6.1) | Rx progression | |
Placebo subcutaneously | 30 | 83 | 60.7 (6.9) |
Values are mean (SD) or median (min-max). Colours denote RoB (green:low, yellow: unclear, red: high). (A) indicates conference abstract.
ACR,American College of Rheumatology; AUSCAN, Australian/Canadian Hand Osteoarthritis Index; CCT, clinical controlled trials; CMC, first carpometacarpal; CO, cross-over trial; FIHOA, Functional Index for Hand OsteoArthritis; i.a., intra-articular; IP, interphalangeal joint; NR, not reported; NRS, numerical rating scale; NSAID, non-steroidal anti-inflammatory drugs; OA, osteoarthritis; RCT, randomised controlled trial; TNF, tumour necrosis factor; VAS, visual analogue scale; WA, wash-out period; WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index.