Lack of beneficial effects of low-dose radiation therapy on hand osteoarthritis symptoms and inflammation: a randomised, blinded, sham-controlled trial

Minten, M.J.M.; Leseman-Hoogenboom, M.M.; Kloppenburg, Margreet; Kortekaas, M.C.; Leer, J.W.H.; Poortmans, Philip; Hoogen, F.H.J. van den; Broeder, Alfons A den; Ende, Cornelia van den

doi:10.1016/j.joca.2018.06.010

Cited by 39 publications

(26 citation statements)

References 42 publications

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“…Despite the weaknesses of both clinical studies [6,7], we agree that future optimized randomized trials with higher patient numbers are needed for inflammatory degenerative diseases that are currently routinely treated with LDRT in Germany. Furthermore, additional randomized data are definitely needed to better define the anti-inflammatory and pain-controlling potential of LDRT as well as its beneficial impact on bone metabolism for arthrosis and enthesopathies.…”

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confidence: 84%

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Low-dose radiotherapy: Mayday, mayday. We’ve been hit!

et al. 2018

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For more than a hundred years the ship cruised through the sea totally unfazed, mighty and big. Over the decades, tens of thousands became acquainted with the luxury and wellness on board. Suddenly, two small icebergs appeared on the horizon ... Low-dose radiation therapy (LDRT) for benign degenerative inflammatory disorders is well established among German-speaking radiotherapists and a growing number of orthopedic specialists. Nationwide, several thousand patients with painful joints or enthesopathies experience significant pain relief every year using this treatment modality [1-5]. The treatment costs are completely covered by the insurance companies without any doubt. Recently, two randomized, blinded, and sham-controlled trials on knee and hand joint osteoarthritis, however, provided evidence that LDRT does not provide any measurable additional benefit [6, 7]. Could it all be about a placebo effect?

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confidence: 84%

“…Minten et al [7] performed a similar randomized, blinded, and sham-controlled trial in a total of 56 patients with hand osteoarthritis. Likewise, the authors did not demonstrate a substantial beneficial effect of LDRT on symptoms and inflammation compared to sham treatment.…”

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confidence: 99%

Low-dose radiotherapy: Mayday, mayday. We’ve been hit!

et al. 2018

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“…A second comparable trial was performed in patients with painful hand OA with !1 inflammatory hand joint on ultrasonography 32 . 29% and 36% responders were seen in the LDRT and sham groups, respectively, with no statistical significant difference between the groups.…”

Section: Novel Treatmentsmentioning

confidence: 99%

Osteoarthritis year in review 2019: epidemiology and therapy

Kloppenburg

Bérenbaum

2020

Osteoarthritis and Cartilage

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411

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s u m m a r yOver the past year many studies and clinical trials have been published in the osteoarthritis (OA) field. This review is based on systematic literature review covering the period May 1 st , 2018 to April 19 th , 2019; the final selection of articles was subjective. Specifically those articles considered to be presenting novel insights and of potential importance for clinical practice, are discussed.Further evidence has emerged that OA is a serious disease with increasing impact worldwide. Our understanding of development of pain in OA has increased. Detailed studies investigating widely used pharmacological treatments have shown the benefits to be limited, whereas the risks seem higher than expected, suggesting further studies and reconsideration of currently used guidelines. Promising new pharmacological treatments have been developed and published, however subsequent studies are warranted. While waiting for new treatment modalities to appear joint replacement is an effective alternative; new data have become available on how long they might last.

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“…2 randomisierte Doppelblind-Studien aus den Niederlanden [25,26] haben keinen Unterschied des Ansprechens auf eine Strahlentherapie im Vergleich zu einer Scheinbestrahlung ergeben. Diese sicherlich qualitativ hochstehenden Ergebnisse werden derzeit in der Fachgesellschaft diskutiert [27].…”

Section: Arthrosenunclassified

Analgetische Strahlentherapie gutartiger Erkrankungen des Skelettsystems

Niewald¹

2020

Arthritis und Rheuma

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ZusammenfassungDer entzündungshemmende Effekt kleiner Strahlendosen ist seit Langem bekannt und strahlenbiologisch gut untermauert. Zahlreiche retrospektive Arbeiten und einige randomisierte Studien weisen darauf hin, dass ein gutes Ansprechen bei Enthesiopathien wie der Fasciitis plantaris, der Achillodynie, der Epicondylitis und z. B. der Tendinitis calcarea der Schulter zu erzielen ist (Ansprechraten von 60–80 %). Auch bei Arthrosen weisen retrospektive Daten auf eine gute Wirksamkeit der Strahlentherapie hin, der randomisierte Nachweis wird derzeit diskutiert und ist Studienfrage. Indiziert ist die Strahlentherapie bei Patienten im Alter von > 40 Jahren und einer minimalen Anamnesedauer von 3–6 Monaten. In dieser Zeit sollten die konservativen Therapiemethoden durchgeführt worden sein. Eine Gesamtdosis von 3–6 Gy wird in zweimal wöchentlichen Sitzungen über 3 Wochen appliziert. Während und nach der Strahlentherapie kann es zu einer kurzzeitigen Schmerzzunahme kommen. Das Ansprechen ist frühestens 3 Monate nach Therapie zu beurteilen. Nebenwirkungen wie z. B. Hautreaktionen werden überaus selten gesehen. Ein vielfach diskutiertes Tumorrisiko liegt nach bisherigen Daten im Sub-Promillebereich.

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Lack of beneficial effects of low-dose radiation therapy on hand osteoarthritis symptoms and inflammation: a randomised, blinded, sham-controlled trial

Abstract: NTR4574 (Dutch Trial Register).

Cited by 39 publications

References 42 publications

Low-dose radiotherapy: Mayday, mayday. We’ve been hit!

Low-dose radiotherapy: Mayday, mayday. We’ve been hit!

Osteoarthritis year in review 2019: epidemiology and therapy

Analgetische Strahlentherapie gutartiger Erkrankungen des Skelettsystems

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