Table 3

Characteristics of studies of main pharmacological interventions (n=33 studies)

RoBStudyDesignInterventionFrequency, durationNOA location, definitionWomen (%)Age (years)Primary outcome
Topical NSAIDs
Altman et al 200952 RCTTopical diclofenac gel 1%4 per day, 8 weeks198ACR, Rx KL1–37763.6 (10.3)VAS pain, AUSCAN, VAS patient global
Topical placebo cream1877764.7 (9.6)
Graber et al 199739 RCTTopical ibuprofen cream3 per day, 2 weeks57ACR or clinical diagnosis isolated CMC OA9165.8 (8.6)FIHOA
Berthollet treatment (local steam bath and finger shower)Daily, 3 weeks598663.2 (10.0)
Michalsen et al 200892RCTDiclofenac gel 10 mg/g2 per day, 4 weeks16CMC, clinical diagnosis and Rx damage10064.3 (9.1)VAS pain
Medicinal leechesOnce in 4 weeks1664.1 (6.4)
Romero et al 201355 RCTTopical diclofenac gel 2%3 per day, 4 weeks65ACR8662 (10.2)NR
Topical herbal cream6595
Talke et al 198550 RCTTopical etofenamate 100 mg/g3 per day, 3 weeks30IP, clinical diagnosis, 'activated'8364.3 (13.5)NR
Oral indomethacin 150 mg/day3 weeks309063.3 (11.0)
Widrig et al 200754 RCTTopical ibuprofen cream 5%3 per day, 3 weeks99ACR6164 (11.4)VAS pain, FIHOA
Topical arnica cream 50%1056764 (12.0)
Zacher et al 200151 RCTTopical diclofenac gel 1%4 per day, 3 weeks165IP, clinical diagnosis, 'activated'8660.7 (9.4)VAS pain improve≥40%
Oral ibuprofen 1200 mg/day3 weeks1569063.2 (9.4)
Dreiser et al 199362 RCTIbuprofen 800 mg/day2 weeks30Rx damage, pain exacerbation8058.5 (1.7)NR
Placebo309060.3 (2.0)
Grifka et al 200463 RCTLumiracoxib 200 mg/day4 weeks205ACR8262.0 (12.1)VAS pain
Lumiracoxib 400 mg/day1938361.0 (12.4)
Placebo1968362.7 (11.7)
Muratore et al 200465
RCTKetoprofen lysine salt 160 mg/day+glucosamine+chondroitin sulfate20 days30Hand, NR100NRNR
Glucosamine+chondroitin sulfate28
Rovetta et al,2001-B49 CCTDexketoprofen-trometamol 50 mg/day3 weeks35ACR, 'active OA'8657.7 (3.4)Morning stiffness (WOMAC)
No intervention1963
Rovetta et al, 2001-A48 CO
Dexketoprofen-trometamol 50 mg/day13 days36ACR, 'active OA'NRNRMorning stiffness and pain (WOMAC)
Paracetamol 1000 mg/day
Seiler 198364 RCTMeclofenamate sodium 300 mg/day4 weeks22Clinical diagnosis,≥1 inflamed DIP and Rx damage9562.5 (34–77)NR
Placebo198465.0 (49–80)
Talke 198550 RCTOral indomethacin 150 mg/day3 weeks30IP, clinical diagnosis, 'activated'8364.3 (13.5)NR
Topical etofenamate 100 mg/g3 per day, 3 weeks309063.3 (11.0)
Zacher et al 200151 RCTOral ibuprofen 1200 mg/day3 weeks156IP, clinical diagnosis,'activated'9063.2 (9.4)VAS pain improve≥40%
Topical diclofenac gel 1%4 per day, 3 weeks1658660.7 (9.4)
Chondroitin sulfate
Gabay et al 201166 RCTChondroitin sulfate 800 mg/day6 months80ACR7363.9 (8.5)VAS pain, FIHOA
Placebo827663.0 (7.2)
Verbruggen 200244 RCTChondroitin polysulphate 50 mg/day intramuscularly3 years66IP, clinical diagnosis and Rx damage9155.2 (6.7)Rx progression
Placebo intramuscularly649756.1 (9.2)
RCTChondroitin sulfate 1200 mg/day3 years44IP, clinical diagnosis and Rx damage9157.6 (7.1)Rx progression
Placebo488855.9 (8.9)
Intra-articular glucocorticoids
Bahadiret al 200973 RCTGlucocorticoid i.a. 20 mg/0.5 mLOnce20CMC, Rx E-L stage II–III10062.9 (9.1)NR
Hyaluronic acid i.a. 5 mg/0.5 mL1 per week, 3 weeks2060.8 (7.3)
Fuchs et al 200674 RCTGlucocorticoid i.a. 10 mg/1 mL1 per week, 3 weeks28CMC, clinical diagnosis and Rx KL>080Median 61.0NR
Hyaluronic acid i.a. 10 mg/1 mL28Median 59.5
Heyworth et al 200868RCTGlucocorticoids i.a.1 mLOnce+1 i.a. placebo, 2 weeks22CMC, Rx E-L stage I–IV9060 (9.4)NR
Hyaluronic acid i.a. 8 mg/1 mL1 per week, 2 weeks288065 (10.6)
Placebo i.a. (1 mL, saline)1 per week, 2 weeks188964 (8.5)
Jahangiri 201493 RCTGluocorticoid i.a. 40 mg/0.5 mL+0.5 mL lidocaineOnce+2 i.a. placebo, 3 weeks30CMC, clinical diagnosis and Rx E-L stage>I7063.3 (10.1)VAS pain
Dextrose i.a. 100 mg/0.5 mL+0.5 mL lidocaine1 per week, 3 weeks307763.9 (9.4)
Mandl,et al
RCTGlucocorticoid i.a. 40 mg/1 mLOnce+1 i.a. placebo,2 weeks65CMC, clinical diagnosis and Rx KL>06866.5 (45–89)NR
Hyaluronic acid i.a. 8 mg/1 mL1 per week, 2 weeks62
Placebo i.a. (1 mL, bupivacaine)1 per week, 2 weeks61
Meenagh et al 200470 RCTGlucocorticoid i.a. 5 mg/0.25 mLOnce20CMC, NR9560.6 (41–71)VAS pain improve≥20%
Placebo i.a. (0.25 mL, saline)208559.3 (46–69)
Monfort et al 201475 RCTGlucocorticoid i.a. 3 mg/0.5 mL1 per week, 3 weeks40CMC, clinical diagnosis and Rx KL1–38862.8 (8.7)FIHOA
Hyaluronic acid i.a. 5 mg/0.5 mL48
Spolidoro,et al
RCTGlucocorticoid i.a.4 mg/0.2 mL (DIP) or 6 mg/0.3 mL(PIP)+0.1 mL lidocaineOnce30IP, clinical diagnosis and Rx osteophyte10060.7 (9.1)VAS pain, VAS joint swelling
Placebo i.a. (0.1 mL, lidocaine)309360.7 (7.3)
Stahl et al 200576 RCTGlucocorticoid i.a. 40 mg/1 mLOnce25CMC, Rx E-L stage II8462 (50–91)NR
Hyaluronic acid i.a. 15 mg/1 mL2792.562 (37–80)
Oral glucocorticoids
Kvien et al 200881 RCTPrednisone 3 mg/day+dipyridamole 200 mg/day6 weeks42ACR, Rx KL>19361.1 (5.0)AUSCAN pain
Placebo419359.6 (5.3)
Wenham et al 201282 RCTPrednisone 5 mg/day4 weeks35ACR, Rx KL>07461.9 (6.6)VAS pain
Placebo358961.1 (9.0)
Basoski et al 201583(A)RCTHydroxychloroquine 400 mg/day24 weeks98ACR8657VAS pain
Kingsbury,et al 201684(A)RCTHydroxychloroquine 200–400 mg/day1 year124ACRNRNRNRS pain
McKendry et al 200159(A)RCTHydroxychloroquine 400 mg/day24 weeks29Hand, NRNRNRNR
Paracetamol 3900 mg/day29
TNF inhibitors
Aitken et al 201746(A)CO (WA+)Adalimumab 40 mg subcutaneously2 subcutaneously per 2 weeks,12 weeks43ACR, erosive (Rx erosion), MRI synovitis7761 (8.4)AUSCAN pain
Placebo subcutaneously
Chevalier et al 201585 RCTAdalimumab 40 mg subcutaneouslyOnce 2 subcutaneously,2 weeks42ACR, Rx damage IPs8762.8 (6.9)VAS pain improve≥50%
Placebo subcutaneously438362.2 (7.0)
Kloppenburg et al 201647 86 87
RCTEtanercept 25–50 mg subcutaneously1 subcutaneously per week, 1 year45IP, ACR, erosive (Rx erosion IP)8259.4 (6.5)VAS pain
Placebo subcutaneously458060.1 (8.7)
Verbruggen et al 201245 RCTAdalimumab 40 mg subcutaneously1 subcutaneously per 2 weeks,
1 year
30IP, ACR, erosive (Rx erosion IP)8761.9 (6.1)Rx progression
Placebo subcutaneously308360.7 (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.